Foreign Body Granulomatous Reaction Mimicking Tumor Recurrence After Lung Cancer Surgery: A Case Series

Q4 Medicine

Open Respiratory Archives Pub Date : 2025-09-03 DOI:10.1016/j.opresp.2025.100481

Marc Paredes , Domingo Madera , Marta Plana Pes , Pere Trias Sabrià , Lara Pijuan , Cruz García , Carlos Déniz , Rosa López Lisbona

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Abstract

Mechanical hemostatic agents, such as oxidized cellulose (Willocell©), are frequently used in thoracic surgery. Although considered safe, they can induce granulomatous reactions that mimic tumor recurrence. In this retrospective study, we analyzed patients from the Hospital Universitari de Bellvitge (July 2024–March 2025) who underwent EBUS due to lymphadenopathies with increased SUV on PET-FDG following surgery for lung cancer. Nine patients, who had undergone anatomical lung resections (VATS or RATS), presented with suspicious lymphadenopathies ipsilateral to the surgical site. EBUS-TBNA revealed no malignancy but showed amorphous material compatible with a foreign body reaction attributable to Willocell©. Only one patient was diagnosed with tumor recurrence.

This case series underscores the importance of maintaining a broad differential diagnosis when evaluating potential causes of increased metabolic activity on PET/CT scans, as its specificity is limited. EBUS-TBNA proves to be a key tool for achieving an accurate diagnosis in these scenarios.

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肺癌手术后异体肉芽肿反应模拟肿瘤复发：一个病例系列

机械止血剂，如氧化纤维素（Willocell©），经常用于胸外科手术。虽然被认为是安全的，但它们可以诱导肉芽肿反应，模仿肿瘤复发。在这项回顾性研究中，我们分析了Bellvitge大学医院（Hospital Universitari de Bellvitge）（2024年7月- 2025年3月）因淋巴结病变而接受EBUS的患者，这些患者在肺癌手术后PET-FDG的SUV增加。9例接受解剖性肺切除术（VATS或RATS）的患者在手术部位的同侧出现可疑的淋巴结病变。EBUS-TBNA未显示恶性肿瘤，但显示与Willocell©引起的异物反应相容的非晶物质。仅有1例患者被诊断为肿瘤复发。本病例系列强调了在评估PET/CT扫描中代谢活动增加的潜在原因时保持广泛鉴别诊断的重要性，因为其特异性有限。事实证明，EBUS-TBNA是在这些情况下实现准确诊断的关键工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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