[Mediastinal sarcoidosis in an oncologic context: role of endoscopic ultrasound-guided fine needle aspiration].

Rev Med Interne

Département d'oncologie médicale, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux, France. Electronic address:

Published: October 2013

Introduction: Sarcoidosis and sarcoid reactions have been previously reported in association with cancer. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a minimally invasive test for investigating mediastinal lymph nodes

Patients And Methods: We conducted a retrospective review of 54 patients undergoing EUS-FNA in a cancer institute for suspected metastatic mediastinal lymph nodes showed by CT-imaging or positron emission tomography (PET). Patients with non-caseating granuloma identified by EUS-FNA were included

Results: EUS-FNA identified non-caseating granuloma in seven out of the 54 included patients. Most of them had positive PET. One patient had a prior history of sarcoidosis before the diagnosis of cancer. Another patient developed micrometastasis associated with sarcoid-like reaction. There was no adverse outcome associated with the EUS-FNA procedure

Conclusions: Sarcoidosis must be included in the differential diagnosis of patients with a history of malignancy who develop mediastinal lymphadenopathy. EUS-FNA is a safe and minimally invasive test to obtain tissue diagnosis.

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http://dx.doi.org/10.1016/j.revmed.2013.04.013DOI Listing

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