Identify sarcoid-like reaction in cancer patients receiving chemotherapy and immunotherapy: dont get into the weeds of SUVmax

Conclusions: To avoid pitfall in PET/CT interpretation, it is important to recognize the sarcoid-like pattern of FDG uptake, which regardless of SUV value is favored to represent a benign rather than a malignant process.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Educational Exhibits Source Type: research

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We describe the case of an 81-year-old male with cT1aN2M1b stage IV pleomorphic carcinoma of the left upper lobe of the lung. After primary treatment with carboplatin and paclitaxel, recurrence was observed in the left supraclavicular lymph node and left adrenal gland. We initiated the administration of nivolumab as a secondary treatment. Reduction was observed in the swelling of the left supraclavicular lymph node and left adrenal gland, but the tumor shadow in the right upper lobe appeared to increase. Bronchoscopy was performed, and the biopsy result showed granulomas; the findings resembled a sarcoid-like granulomatous...
Source: Case Reports in Oncology - Category: Cancer & Oncology Source Type: research
AbstractA 40-year-old male was hospitalized with renal impairment and severe hypercalcemia. His concentration of serum IgG4 was high, but serum whole PTH, 1 –25(OH)2 vitamin D3 and PTHrP were not elevated. Computed tomography showed swelling of the bilateral lacrimal glands and systemic lymphadenopathy. The histological findings of lacrimal gland biopsy fulfilled the diagnostic criteria of IgG4-related ophthalmic disease (IgG4ROD). Bone scintigraphy showed increased ectopic uptake in the stomach, heart, lungs, and kidneys. He died on day 16 of admission, although the therapies for hypercalcemia were continued. Autops...
Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research
Introduction: Binding of programmed cell death 1 (PD-1) ligands to PD-1 receptors found on T cells, inhibits T-cell proliferation and contributes to immune tolerance and inhibition of tumor surveillance. Nivolumab is a monoclonal antibody that binds to PD-1 receptor and inhibits this pathway. Given its antitumor capabilities, this medication was recently approved in Canada and the U.S. for the treatment of unresectable or metastatic melanoma, metastatic nonsmall cell lung cancer, renal carcinoma, and classical Hodgkin lymphoma.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
SummaryThe administration of target inhibitors is paramount to grant the longest survival in patients with ALK-positive non-small cell lung cancer (NSCLC). The eventual resistance to tyrosine kinase inhibitors (TKI) is monitored clinically and radiologically for prompt molecule shift to further generation TKI, if available. However, the early radiological detection of progression pattern (e.g. nodule onset) should be regarded with caution because overlaps exist with non-tumor cell proliferation and/or accumulation. Here we report the case of a stage IVALK-rearranged NSCLC patient exposed to serial crizotinib, brigatinib, c...
Source: Investigational New Drugs - Category: Drugs & Pharmacology Source Type: research
ConclusionsImmune-related adverse effects often occur within 3 –6 months of receiving immune checkpoint inhibitor therapy, with some reports of late toxicity. This report highlights a case of probable neurosarcoidosis nearly a year after discontinuation of immune checkpoint therapy. The potential for durable responses after discontinuation of therapy also li kely underscores a potential for late toxicity. In patients presenting with new or unexplained symptoms after checkpoint inhibitor therapy, the index of suspicion for an immune-related adverse effect should remain high, irrespective of timing.
Source: Journal for Immunotherapy of Cancer - Category: Cancer & Oncology Source Type: research
Recently, immune checkpoint inhibitors have revolutionized cancer care by enhancing anti-tumor immunity. However, by virtue of stimulating the immune system, they can lead to immune-related adverse events (irAEs). Neurologic irAEs are uncommon but are becoming increasingly recognized and can be quite serious or even fatal. Furthermore, central nervous system (CNS) manifestations may be difficult to distinguish from CNS metastases, posing management challenges. Here, we describe a patient who developed exacerbation of sarcoidosis leading to CNS involvement following dual checkpoint blockade with nivolumab and ipilimumab for...
Source: Case Reports in Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 24 July 2018Source: Research in Veterinary ScienceAuthor(s): E. Semik-Gurgul, T. Ząbek, A. Fornal, M. Wnuk, K. Pawlina-Tyszko, A. Gurgul, J. Klukowska-Rötzler, C. Koch, K. Mählmann, M. Bugno-PoniewierskaAbstractGenetic and epigenetic alterations in the equine sarcoid, a locally invasive skin tumour of equids, are still poorly characterized. Numerous studies have provided reliable evidence for the relationship between the development of cancer and the loss of function of a number of tumour suppressor genes. In the present study, we assessed methylation levels in the promoter reg...
Source: Research in Veterinary Science - Category: Veterinary Research Source Type: research
This report presents a case with isolated mediastinal lymphadenopathy caused by Rhodococcus equi infection in a 71-year-old immunocompetent patient.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
We describe the cautionary case of a patient with advanced-stage large B-cell lymphoma (DLBCL). After combination chemotherapy, CT-PET revealed a persistent focus of likely DLBCL for which he received radiotherapy. Follow-up CT-PET showed diffuse hypermetabolic adenopathy and recurrent DLBCL was presumed. As part of clinical trial assessment, multiple biopsies showed non-caseating lymphadenitis consistent with sarcoidosis. No treatment for asymptomatic sarcoidosis was required and 18 months later he remains cancer-free. The presentation of sarcoidosis masquerading as recurrent DLBCL highlights the importance of tissue samp...
Source: Leukemia Research Reports - Category: Hematology Source Type: research
Publication date: May–June 2018Source: Revista Española de Medicina Nuclear e Imagen Molecular (English Edition), Volume 37, Issue 3Author(s): F.J. Gómez-de la Fuente, I. Martínez-Rodríguez, M. de Arcocha-Torres, R. Quirce, J. Jiménez-Bonilla, N. Martínez-Amador, I. BanzoAbstractObjective11C-Choline PET/CT has demonstrated good results in the restaging of prostate cancer (PCa) with high serum prostate specific antigen (PSA), but its use in patients with low serum PSA is controversial. Our aim was to evaluate the contribution of 11C-Choline PET/CT in patients with PCa, biochemical relapse and PSA
Source: Revista Espanola de Medicina Nuclear e Imagen Molecular - Category: Nuclear Medicine Source Type: research
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