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

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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.

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Ethical Statement

The authors declare that their work conforms to the guidelines set forth in the Helsinki Declaration of 1975, as revised in 2000 (5), concerning human and animal rights, and that they followed the policy concerning informed consent as shown on the following sites: http://www.springer.com/authors?SGWID=0-111-2-608209-0.

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The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan

    Yuki Bekki, Yasue Kimura, Masaru Morita, Yoko Zaitsu, Hiroshi Saeki, Tatsuro Okamoto, Eiji Oki & Yoshihiko Maehara

  2. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan

    Shingo Baba

  3. Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan

    Yoshinao Oda

Authors
  1. Yuki Bekki
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  2. Yasue Kimura
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  3. Masaru Morita
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  4. Yoko Zaitsu
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  5. Hiroshi Saeki
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  6. Tatsuro Okamoto
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  7. Eiji Oki
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  8. Shingo Baba
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  9. Yoshinao Oda
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  10. Yoshihiko Maehara
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Correspondence to Masaru Morita.

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Bekki, Y., Kimura, Y., Morita, M. et al. Esophageal cancer associated with bilateral hilar lymphadenopathy caused by sarcoid-like reactions: a report of two cases. Esophagus 12, 322–326 (2015). https://doi.org/10.1007/s10388-014-0454-4

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  • DOI: https://doi.org/10.1007/s10388-014-0454-4

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