模拟淋巴结转移的异物反应在癌症切除术后并不罕见。

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Thoracic and Cardiovascular Surgeon Pub Date : 2024-04-01 Epub Date: 2023-08-28 DOI:10.1055/a-2161-0690
Berk Cimenoglu, Talha Dogruyol, Attila Ozdemir, Mesut Buz, Dilek Ece, Sevda Sener Comert, Recep Demirhan
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引用次数: 0

摘要

背景: 曾接受过癌症手术的患者中,伴有18-氟脱氧葡萄糖高摄取的纵隔淋巴结病复发令人担忧,需要进行侵入性诊断程序。术中放置氧化纤维素以控制轻微出血可能会在术后检查时通过解剖纵隔淋巴结内的异物反应导致转移样图像。在这项研究中,我们研究了纵隔淋巴结转移的临床病理特征和异物反应的频率。方法: 包括2016年1月至2021年8月期间接受癌症手术的患者,以及随后通过支气管内超声引导下经支气管针抽吸(EBUS-TBNA)评估纵隔复发的患者。根据EBUS-TBNA结果将患者分为转移、异物和反应性。比较这些患者的临床病理特征,并仔细检查异物组患者的特征。结果: 由于怀疑纵隔复发,在术后随访期间对34名患者进行了EBUS-TBNA检查。EBUS-TBNA病理检查显示18例(52.9%)有转移,10例(29.4%)有异物反应,6例(17.6%)有反应性淋巴结。转移组和异物组的平均最大标准化摄取值(SUVMax)为9.39 ± 4.69和5.48 ± 分别为2.54(p = 0.022)。转移组手术与EBUS-TBNA的时间间隔为23.72 ± 10.48个月,而它是14.90 ± 异物组12.51个月(p = 0.015)。结论: 类似纵隔淋巴结转移的异物反应并不罕见。与转移性淋巴结病相比,纵隔淋巴结病的医源性原因与早期表现和较低的SUVMax有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Foreign Body Reaction Mimicking Lymph Node Metastasis is Not Rare After Lung Cancer Resection.

Background:  Mediastinal lymphadenopathies with high 18-fluorodeoxyglucose uptake in patients previously operated on for lung cancer are alarming for recurrence and necessitate invasive diagnostic procedures. Peroperative placement of oxidized cellulose to control minor bleeding may lead to a metastasis-like image through a foreign body reaction within the dissected mediastinal lymph node field at postoperative examinations. In this study, we investigated clinicopathological features and the frequency of foreign body reaction mimicking mediastinal lymph node metastasis.

Methods:  Patients who underwent surgery for lung cancer between January 2016 and August 2021 and who were subsequently evaluated for mediastinal recurrence with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) were included. Patients were grouped according to the results of EBUS-TBNA as metastasis, foreign body, and reactive. Clinicopathological features of these patients were compared and characteristics of patients in the foreign body group were scrutinized.

Results:  EBUS-TBNA was performed on a total of 34 patients during their postoperative follow-up due to suspicion of mediastinal recurrence. EBUS-TBNA pathological workup revealed metastasis in 18 (52.9%), foreign body reaction in 10 (29.4%) and reactive lymph nodes in 6 (17.6%) patients. Mean maximum standardized uptake value (SUVMax) for metastasis group and foreign body group were 9.39 ± 4.69 and 5.48 ± 2.54, respectively (p = 0.022). Time interval between the operation and EBUS-TBNA for the metastasis group was 23.72 ± 10.48 months, while it was 14.90 ± 12.51 months in the foreign body group (p = 0.015).

Conclusion:  Foreign body reaction mimicking mediastinal lymph node metastasis is not uncommon. Iatrogenic cause of mediastinal lymphadenopathy is related to earlier presentation and lower SUVMax compared with metastatic lymphadenopathy.

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来源期刊
CiteScore
3.40
自引率
6.70%
发文量
365
审稿时长
3 months
期刊介绍: The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.
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