Importance of mediastinal granulomatous/sarcoid-like lymphadenopathy in extrathoracic malignancies

IF 1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY

Diagnostic Cytopathology Pub Date : 2024-05-01 DOI:10.1002/dc.25337

Serhat Erol MD, Aslıhan Gurun Kaya MD, Fatma Arslan MD, Mirac Oz MD, Deniz Doğan Mulazimoglu MD, Ozlem Isık MD, Aydin Ciledag MD, Koray Ceyhan MD, Demet Karnak MD, Elif Sen MD, Gokhan Celik MD, Akin Kaya MD, Ismail Savas MD

{"title":"Importance of mediastinal granulomatous/sarcoid-like lymphadenopathy in extrathoracic malignancies","authors":"Serhat Erol MD, Aslıhan Gurun Kaya MD, Fatma Arslan MD, Mirac Oz MD, Deniz Doğan Mulazimoglu MD, Ozlem Isık MD, Aydin Ciledag MD, Koray Ceyhan MD, Demet Karnak MD, Elif Sen MD, Gokhan Celik MD, Akin Kaya MD, Ismail Savas MD","doi":"10.1002/dc.25337","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>In patients with extrathoracic malignancies (ETM), granulomatous lymph adenopathy called sarcoid-like reactions (SLR) can be seen in the regional or draining lymph nodes. We hypothesized that SLR may be a sign of imminent metastasis and investigated the clinical course and rate of recurrence in patients with ETM and granulomatous mediastinal lymphadenopathy (MLN).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In this retrospective observational study, we reviewed the medical files of patients with known ETM and who underwent EBUS-TBNA for initial staging or detection of recurrence from 2011 to 2023. Patients with granulomatous MLN were included.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Forty-one patients (29 female) enrolled in the study. Breast and colorectal carcinomas were the most common malignancies. A total of 81 lymph nodes were sampled. The final diagnosis of patients was five sarcoidosis, one tuberculosis, one second primary, one drug reaction, and 33 SLR. Among patients with SLR, in one patient lymph nodes progressed during the follow-up and were accepted as false-negative without confirmatory biopsy. The negative predictive value (NPV) of granulomatous MLN for metastasis was 97.05%.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Granulomatous MLN may be due to tuberculosis, drug reaction, sarcoidosis, or SLR in patients with ETM. SLR has a high NPV in patients with ETM. Follow-up imaging rather than confirmatory biopsy is reasonable in these patients.</p>\n </section>\n </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dc.25337","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostic Cytopathology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/dc.25337","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

In patients with extrathoracic malignancies (ETM), granulomatous lymph adenopathy called sarcoid-like reactions (SLR) can be seen in the regional or draining lymph nodes. We hypothesized that SLR may be a sign of imminent metastasis and investigated the clinical course and rate of recurrence in patients with ETM and granulomatous mediastinal lymphadenopathy (MLN).

Methods

In this retrospective observational study, we reviewed the medical files of patients with known ETM and who underwent EBUS-TBNA for initial staging or detection of recurrence from 2011 to 2023. Patients with granulomatous MLN were included.

Results

Forty-one patients (29 female) enrolled in the study. Breast and colorectal carcinomas were the most common malignancies. A total of 81 lymph nodes were sampled. The final diagnosis of patients was five sarcoidosis, one tuberculosis, one second primary, one drug reaction, and 33 SLR. Among patients with SLR, in one patient lymph nodes progressed during the follow-up and were accepted as false-negative without confirmatory biopsy. The negative predictive value (NPV) of granulomatous MLN for metastasis was 97.05%.

Conclusion

Granulomatous MLN may be due to tuberculosis, drug reaction, sarcoidosis, or SLR in patients with ETM. SLR has a high NPV in patients with ETM. Follow-up imaging rather than confirmatory biopsy is reasonable in these patients.

Abstract Image

查看原文本刊更多论文

纵隔肉芽肿/类肉芽肿淋巴结病在胸腔外恶性肿瘤中的重要性

背景胸外恶性肿瘤（ETM）患者的区域淋巴结或引流淋巴结可出现肉芽肿性淋巴腺病，称为类肉芽肿反应（SLR）。我们假设 SLR 可能是即将发生转移的征兆，并对 ETM 和肉芽肿性纵隔淋巴结病（MLN）患者的临床病程和复发率进行了调查。方法在这项回顾性观察研究中，我们回顾了 2011 年至 2023 年期间已知 ETM 并接受 EBUS-TBNA 进行初步分期或复发检测的患者的医疗档案。结果41名患者（29名女性）参加了研究。乳腺癌和结直肠癌是最常见的恶性肿瘤。共采集了 81 个淋巴结样本。患者的最终诊断为 5 例肉芽肿病、1 例结核病、1 例第二原发性、1 例药物反应和 33 例 SLR。在 SLR 患者中，有一名患者的淋巴结在随访期间出现进展，未经活检确诊即被视为假阴性。肉芽肿性 MLN 转移的阴性预测值（NPV）为 97.05%。在 ETM 患者中，SLR 的 NPV 很高。对这些患者进行随访成像而非确诊活检是合理的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Diagnostic Cytopathology 医学-病理学

CiteScore

2.60

自引率

7.70%

发文量

163

审稿时长

3-6 weeks

期刊介绍： Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.