Esophageal cancer associated with bilateral hilar lymphadenopathy caused by sarcoid-like reactions: a report of two cases

We report two patients with esophageal cancer accompanied by bilateral hilar lymphadenopathy or accumulation on [18F]-fluorodeoxyglucose positron emission tomography–computed tomography. The first patient underwent surgery because the enlarged bilateral hilar lymph nodes were considered to be nonmalignant lesions owing to superficial carcinoma and symmetric distribution of the hilar lymph nodes. The second patient received chemotherapy, which caused the main tumor to shrink and decreased [18F]-fluorodeoxyglucose uptake. However, chemotherapy did not affect the hilar lymphadenopathy, which suggests that it was caused by reactive changes rather than metastasis. In both cases, esophagectomy and histological findings revealed that the hilar nodes were caused by sarcoid-like reactions. These findings profoundly influenced our treatment decisions for these patients.
Source: Esophagus - Category: Gastroenterology Source Type: research