Cancer Res Treat.  2014 Jul;46(3):317-321.

Case Report of Pulmonary Sarcoidosis Suspected to be Pulmonary Metastasis in a Patient with Breast Cancer

• Kim HS
• Lee SY
• Oh SC
• Choi CW
• Kim JS
• Seo JH

Abstract

Standard endocrine therapy and chemotherapy can induce long-term remission in breast cancer patients; however, breast cancer can recur at any site. Pulmonary nodules with lymphadenopathy in advanced cancer patients are likely to be assumed as metastases. A 44-year-old woman with a history of breast cancer was presented to our institution with abnormal findings on 18-fluorodeoxyglucose positron emission tomography imaging, which suggested lung metastasis. She had previously been diagnosed with breast cancer (T1N2M0, Stage IIIa, intraductal carcinoma, triple negative cancer). Histological analysis of the mediastinal lymph node biopsy demonstrated sarcoidosis, showing a chronic, non-caseating, granulomatous inflammation. Our case highlights the need for non-malignant diagnoses in those with prior malignancies, and the need for histological evaluations in the event of first recurrence following potentially curative therapy.

Keyword

Breast neoplasms; Sarcoidosis; Positron-emission tomography; Neoplasm metastasis

MeSH Terms

Adult
Biopsy
Breast Neoplasms*
Carcinoma, Intraductal, Noninfiltrating
Diagnosis
Drug Therapy
Female
Humans
Inflammation
Lung
Lymph Nodes
Lymphatic Diseases
Neoplasm Metastasis*
Positron-Emission Tomography
Recurrence
Sarcoidosis
Sarcoidosis, Pulmonary*

Figure

• 

  Fig. 1. Positron emission tomography-computed tomography scan of the patient. Multiple new hypermetabolic lesions were observed in the parenchyma of both lungs, both thoracic pleura, and multiple lymph nodes.

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  Fig. 2. Chest computed tomography scan. (A, B) Multiple lymphadenopathies were seen on both sagittal (A) and axial (B) sections in a mediastinal setting. (C) Faint ground-glass opacities and fine reticular densities were observed on both lower lungs. These findings were also observed on both upper subpleural lungs.

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  Fig. 3. Pathologic findings for the mediastinal lymph node tissue. Chronic non-caseating granulomatous inflammation was observed (H&E staining; A, ×100; B, ×200; C, ×400).

Reference

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