The combination of EBUS-TBNA and the PAB antibody led to a successful treatment for lung cancer in a patient with asymptomatic sarcoidosis mimicking nodal metastasis

Publication date: Available online 18 October 2018Source: Respiratory Medicine Case ReportsAuthor(s): Mari Tone, Nobuyasu Awano, Minoru Inomata, Naoyuki Kuse, Tatsunori Jo, Hanako Yoshimura, Yoshiaki Furuhata, Tamiko Takemura, Toshio Kumasaka, Takehiro IzumoAbstractCorrect staging of lung cancer is important for the selection of the best therapy, but discriminating between lymphadenopathy from lung cancer and from sarcoidosis by imaging examinations is difficult. Additionally, distinguishing lymphadenopathy of sarcoidosis from sarcoid reactions which are sometimes caused by lung cancer is difficult on imaging and pathological findings. A 73-year-old woman was diagnosed as lung cancer clinical T1bN3M0 stage ШB based on false-positive 18F-fluoro-2-deoxyglucose positron emission tomography uptake. Because the effects of chemotherapy were different between the lymphadenopathy and the primary lesion, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was performed and revealed sarcoidosis as the cause of the lymphadenopathy with using a specific monoclonal antibody against Propionibacterium acnes (PAB antibody). Accordingly, the stage was changed to clinical T1bN0M0 stage ІA, for which radical operation was performed. EBUS-TBNA should be performed aggressively when the effect of chemotherapy is different between lymphadenopathies and other lesions, and the PAB antibody can help to discriminate between sarcoidosis and sarcoid reactions caused by lung can...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research

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Abstract A 69-year-old woman was diagnosed with sarcoidosis, which was not treated with corticosteroid therapy. Her levels of angiotensin converting enzyme decreased significantly over 4 years and a mass lesion was detected near the lower part of her left main bronchus, and diagnosed as small cell lung cancer (SCLC). Treatment of the SCLC with a series of chemotherapeutic agents produced excellent results. The pulmonary sarcoidosis did not show any deterioration despite the frequent use of amrubicin, which is known to be a cause of interstitial pneumonia. This is a case report of SCLC complicated with sarcoidosis ...
Source: Journal of Nippon Medical School - Category: Universities & Medical Training Authors: Tags: J Nippon Med Sch Source Type: research
Conclusion: The pillars of radiological diagnosis of destructive pulmonary TB are less thickness of the cavity wall, even interior contouring, rounded polygonal form. Non-tuberculous and cancer cavities are characterized by thicker walls, uneven interior contouring, polygonal fissured form.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Tuberculosis Source Type: research
Conclusion: The surviving patients ameliorated without treatment. ATS criteria for nontuberculous mycobacterial lung disease were not met in the majority of cases. Clinical significance is uncertain. M. basiliensis seems to cause colonization or asymptomatic infection rather than disease.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Tuberculosis Source Type: research
In cases of hard rubbery lymph nodes like in Sarcoidosis and Lymphoma, it is sometimes difficult to obtain optimum cytology samples during EBUS TBNA (Transbronchial needle aspiration cytology) and thus the diagnostic yield of EBUS TBNA samples drops down to 60%. An EBUS TBNB sample from such lymph nodes can help to increase the diagnostic yield.Methods: We did a Pilot study in patients presenting with hard rubbery lymph nodes during EBUS TBNA, EBUS guided Transbronchial biopsy of the subcarinal lymph node was done with small size biopsy forceps. Diagnostic yield of biopsy samples was compared with EBUS TBNA cytology result...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
We describe a cohort of patients who have evidence of granulomatous inflammation during EBUS-TBNA (endobronchial ultrasound-guided transbronchial needle aspiration) done for the investigation of sarcoidosis and staging of a known lung cancer.Out of 800 EBUS performed between May 2010- Nov 2017, 500 yielded a benign diagnosis (men 55.6%). Rapid on-site evaluation by a cytopathologist was done in 82% of procedures and yielded a diagnosis in 86.8%.In the setting of suspected sarcoidosis (59.3%), the mean diagnostic yield was 61.05%, ATS Station 7 being the most commonly sampled lymph node (66.67%)Granulomatous inflammation wa...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung Cancer Source Type: research
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and positron emission tomography (PET) standard uptake values (SUV) are useful methods for evaluating mediastinal lymph node pathology.The aim this study was to compare EBUS TBNA and PET suv results in benign, granulomatous and malignant disease. The files of 151 patients who had FDG-PET scanning and underwent EBUS-TBNA between 2015-2017 were reviewed. The diagnoses were confirmed by needle aspiration cytology, histopathology and clinical follow-up. Malignant diseases included lung cancers, metastasis and lymphomas. Granulomatous diseases were mai...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung Cancer Source Type: research
Conclusion: Positive microbiological findings in mediastinal lymph node biopsy were infrequent in patients with sarcoidosis and lung cancer with generally similar microbiological profiles.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sarcoidosis and other granulomatous ILD/DPLD Source Type: research
Conclusion: Lymphocyte profiles in enlarged mediastinal nodes can be analyzed from EBUS-TBNA samples by FCM, likely helping in elucidating the pathophysiology of these diseases.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sarcoidosis and other granulomatous ILD/DPLD Source Type: research
CONCLUSIONS: Knowledge of this toxicity is crucial as the clinical signs and radiological patterns may suggest tumour progression. PMID: 30220489 [PubMed - as supplied by publisher]
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Tags: Rev Mal Respir Source Type: research
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
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