Esophageal cancer associated with bilateral hilar lymphadenopathy caused by sarcoid-like reactions: a report of two cases

Yuki Bekki, Yasue Kimura, Masaru Morita, Yoko Zaitsu, Hiroshi Saeki, Tatsuro Okamoto, Eiji Oki, Shingo Baba, Yoshinao Oda, Yoshihiko Maehara

Research output: Contribution to journalArticle

Abstract

Hilar lymph node metastasis of esophageal cancer is considered to be a distant metastasis and is not indicated for surgical resection. However, its diagnosis is difficult when accompanied by inflammatory diseases such as sarcoidosis. We report two patients with esophageal cancer accompanied by bilateral hilar lymphadenopathy or accumulation on [18F]-fluorodeoxyglucose positron emission tomography–computed tomography. The first patient underwent surgery because the enlarged bilateral hilar lymph nodes were considered to be nonmalignant lesions owing to superficial carcinoma and symmetric distribution of the hilar lymph nodes. The second patient received chemotherapy, which caused the main tumor to shrink and decreased [18F]-fluorodeoxyglucose uptake. However, chemotherapy did not affect the hilar lymphadenopathy, which suggests that it was caused by reactive changes rather than metastasis. In both cases, esophagectomy and histological findings revealed that the hilar nodes were caused by sarcoid-like reactions. These findings profoundly influenced our treatment decisions for these patients.

Original languageEnglish
Pages (from-to)322-326
Number of pages5
JournalEsophagus
Volume12
Issue number3
DOIs
Publication statusPublished - Jul 1 2015

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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    Bekki, Y., Kimura, Y., Morita, M., Zaitsu, Y., Saeki, H., Okamoto, T., Oki, E., Baba, S., Oda, Y., & Maehara, Y. (2015). Esophageal cancer associated with bilateral hilar lymphadenopathy caused by sarcoid-like reactions: a report of two cases. Esophagus, 12(3), 322-326. https://doi.org/10.1007/s10388-014-0454-4