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Carcinoma Breast Presenting with Concurrent Extensive Lymph Nodal Sarcoidosis
Address for correspondence: Dr. Manish Ora, Department of Nuclear Medicine, SGPGIMS, Lucknow - 226 014, Uttar Pradesh, India. E-mail: drmanishora@yahoo.com
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Received: ,
Accepted: ,
This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
Abstract
Sarcoidosis is a systemic disease characterized by noncaseating granulomas involving any organ. Concurrent carcinoma breast with sarcoidosis is a rare occurrence. A 51-year-old female presented with right breast lump and was diagnosed with infiltrating ductal carcinoma with lymph nodal (LN) metastases (estrogen receptor, progesterone receptor positive, and HER2neu negative). Baseline fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scan revealed breast mass with multiple LNs. Biopsy of iliac and internal mammary LNs indicated granulomatous lymphadenitis. A possible diagnosis of sarcoidosis was considered. End of chemotherapy (4 EC, 12 paclitaxel), FDG PET/CT revealed a complete metabolic response in breast mass. Most lymph nodes were resolved. Modified radical mastectomy specimen was negative for breast malignancy with granulomatous lymphadenitis in LNs.
Keywords
Breast carcinoma
granulomatous disease
sarcoidosis
Sarcoidosis is a systemic disease characterized by noncaseating granulomas involving any organ. It commonly affects lungs and intrathoracic LNs.[1] The diagnosis is based on consistent clinical and radiological presentation, nonnecrotizing granulomatous, and excluding other causes of granulomatosis.[2] CD4+lymphocytes and activated macrophages express GLUT-1 and GLUT-3 glucose transporters in the cell membrane, similar to neoplastic cells.[3] Significant FDG accumulation is noted in FDG PET/CT in sarcoidosis [Figures 1 and 2]. It remains one of the common causes of false positive uptake in inflammatory pathologies, apart from sarcoid-like reactions and other granulomatous diseases.[4] In most patients, sarcoidosis precedes or follows breast cancer diagnosis.[5] Concurrent carcinoma breast with sarcoidosis is a rare occurrence.[6]
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
Conflicts of interest
There are no conflicts of interest.
Acknowledgments
I/we have not received substantial contributions from noncontributors and no contributor has been omitted.
Nil.
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