Mediastinal sarcoid-like reaction in cancer patients.

Sarcoidosis is a multisystem disease of unknown origin characterized by the presence of noncaseating epithelioid cell granulomas. When these granulomas develop in the lymph nodes, and the patient does not meet criteria for the diagnosis of systemic sarcoidosis we refer to this as a sarcoid-like reaction. Because of the clinical implications of the diagnosis of lymph node metastasis, mediastinoscopy plays a key role in the differential diagnosis in these patients. We conducted a retrospective chart review of all patients who had undergone mediastinoscopy in our hospital from 2010 to 2015 with a diagnostic of sarcoidosis or sarcoid-like reaction and history of solid organ malignancy. Seventy-four mediastinoscopies were performed by three different surgeons. There were 9 cases of biopsy-proven presence of noncaseating epithelioid cell granulomas and the stain and the culture for acid-fast Bacilli and fungi were negative. 5 patients met criteria for the diagnosis of systemic sarcoidosis. 3 of the 4 patients who did not have a diagnosis of systemic sarcoidosis had a history of malignancy organ solid. We present these 3 cases in order to focus on sarcoid-like reaction in cancer patients.