Tuberc Respir Dis.  2008 Jul;65(1):52-56. 10.4046/trd.2008.65.1.52.

A Case of Thyroid Cancer Combined with Pulmonary Sarcoidosis

• Kim SJ
• Lim TK
• Kim C
• Hwang YI
• Park S
• Jang SH
• Min K
• Lee IJ
• Hwang HS
• Lee JW
• Kim DG

• KMID: 1478218
• DOI: http://doi.org/10.4046/trd.2008.65.1.52

Abstract

Sarcoidosis is a systemic granulomatous disease that primarily affects the lung and lymphatic system of the body. Since Brincker first noted a statistically significant increase of malignant tumors among sarcoidosis patients, there have been several reports on simultaneously developed sarcoidosis and malignancy. A 30-year-old man was admitted to our hospital because of multiple enlarged mediastinal lymph nodes. The patient had been well until approximately 10 days before admission, when he developed a cough. Chest X-ray and computed tomography (CT) of the chest that were performed at the outpatient department revealed multiple enlarged mediastinal lymph nodes. Cervical lymph node biopsy revealed both non-caseating granuloma and metastatic papillary carcinoma, whereas the mediastinal lymph node showed only non-caseating granuloma. The thyroid gland surgical specimen showed papillary carcinoma. We report here on a case of a 30-year-old man who had sarcoidosis and thyroid cancer, and we include a review of the literature.

Keyword

Sarcoidosis; Thyroid cancer

MeSH Terms

Adult
Biopsy
Carcinoma, Papillary
Cough
Granuloma
Humans
Lung
Lymph Nodes
Lymphatic System
Outpatients
Sarcoidosis
Sarcoidosis, Pulmonary
Thorax
Thyroid Gland
Thyroid Neoplasms

Figure

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  Figure 1 Chest X-ray shows bilateral hilar lymphadenopathy.

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  Figure 2 Chest CT shows bilateral hilar and mediastinal lymphadenopathy and wide spread small nodules with a bronchovascular distribution in both lungs.

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  Figure 3 (A) Multiple well-formed small non-caseating granulomas are observed in cervical lymph nodes (short arrows). A multinucleated giant cell is also seen (arrow head) (H&E stain, ×100). (B) Metastatic papillary carcinoma from thyroid is seen in lymph nodes (long arrows) (H&E stain, ×100).

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  Figure 4 18F-FDG PET/CT reveals multiple lymphadenopathy with FDG hypermetabolism in bilateral hilar & mediastinal (A, D), right supraclavicular (B, arrow) and mesenteric areas (E). A thyroid nodule located in left lower thyroid gland shows no demonstrable FDG hypermetabolism (B, arrow head). Perithyroidal lymph node with mild FDG hyperactivity (C, arrow) has proved a metastatic and sarcoidosis node. Small peribronchovascular pulmonary nodules are seen in right upper and right lower lobes with faint increased FDG uptake (D).

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  Figure 5 Thyroid gland surgical specimen reveals papillary carcinoma (H&E stain, ×100).

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  Figure 6 Multiple non-caseating granulomas (arrow) and metastatic papillary carcinoma from thyroid (asterisk) are observed in a perithyroidal lymph node (H&E stain, ×40).

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