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The Korean Journal of Pathology 2008;42(2): 108-112.
Sarcoidosis Associated with Adenocarcinoma of the Lung: A Case Report.
Joon Seon Song, Seungkoo Lee, Yong Hee Kim, Se Jin Jang
1Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. jangsejin@amc.seoul.kr
2Department of Pathology, Gangwon National University Hospital, Chuncheon, Korea.
3Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Sarcoidosis and malignant neoplasm are frequently encountered pulmonary diseases, but their combined existence in the same patient is rare. As sarcoidosis usually presents as mediastinal lymphadenopathy, its concurrence in lung cancer patient radiologically mimics mediastinal metastasis and this can be possibly interpreted as unresectable disease. We report here on a case of lung adenocarcinoma associated with sarcoidosis that developed in a 64 year-old male who underwent surgical resection. Radiological examinations revealed 5.7 cm-sized mass in the right upper lobe with an enlargement of the bilateral supraclavicular, highest mediastinal, subcarinal and the upper and lower paratracheal lymph nodes. Histologic examination showed a well differentiated adenocarcinoma with non-caseating epithelioid granulomas in the lung. The enlarged peribronchial and mediastinal lymph nodes also revealed sarcoid granulomas without cancer metastasis. A good prognosis may be expected for those cases of lung cancers with non-caseating granulomas in the regional lymph nodes. The patient presently has no symptoms or signs of tumor, without further treatment since his surgery.
Key Words: Sarcoidosis; Adenocarcinoma; Lymph Node