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Case Reports
. 2023 Mar 1;15(3):e35648.
doi: 10.7759/cureus.35648. eCollection 2023 Mar.

Sarcoid-Like Reactive Lymphadenopathy in Metastatic Synovial Sarcoma

Gundip S Dhillon  1 , Yema Jalal  1 , Vishisht Mehta  2
Affiliations
Case Reports

Sarcoid-Like Reactive Lymphadenopathy in Metastatic Synovial Sarcoma

Gundip S Dhillon et al. Cureus. .

Abstract

A 56-year-old male underwent treatment for sarcoma with metastases to the lungs. Follow-up imaging revealed multiple pulmonary nodules and masses with a favorable response on positron emission tomography (PET) scanning showing enlarging mediastinal lymph nodes concerning for progression of the disease. To evaluate the lymphadenopathy, the patient underwent bronchoscopy with endobronchial ultrasound and transbronchial needle aspiration. The lymph nodes were negative for cytology but showed granulomatous inflammation. Granulomatous inflammation is a rare occurrence in patients with concurrent metastatic lesions and is exceedingly rare in cancers that have not originated in the thorax. This case report highlights the clinical significance of sarcoid-like reactions in the mediastinal lymph nodes and the need for further investigation.

Keywords: lymph nodes pathology; noncaseating granuloma; sarcoid like reaction; sarcoma soft tissue; synovial sarcoma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. FDG-PET scan showing FDG avidity in the subcarinal LN (September 2022)
FDG, fluorodeoxyglucose, PET, positron emission tomography, LN, lymph node
Figure 2
Figure 2. FDG-PET scan showing improving FDG avidity in the subcarinal LN (January 2023)
FDG, fluorodeoxyglucose, PET, positron emission tomography, LN, lymph node
See this image and copyright information in PMC

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