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Hilar and mediastinal sarcoid-like reaction after the treatment of malignant tumors: imaging features and natural course on 18F-FDG-PET/CT

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Abstract

Purpose

This study aimed to assess the imaging features and natural course of hilar and mediastinal sarcoid-like reaction on 18F-fluorodeoxyglucose (FDG) PET/CT after the treatment of malignancies.

Methods

Sixteen patients with the appearance of sarcoid-like reaction seen on 18F-FDG-PET/CT after treatment were included. Hilar and mediastinal lymph node metastases were pathologically or clinically ruled out. Posttreatment 18F-FDG-PET/CT imaging features were assessed.

Results

The maximum standardized uptake values of sarcoid-like reaction were 3.8–13.6 (mean 6.8). FDG uptake of hilar nodes was symmetrical in 12 (75%) patients and asymmetrical in 4 (25%). The time interval between the initiation of therapy and appearance of sarcoid-like reaction was 9–86 months (median 27.1 months). Among 14 patients who underwent further follow-up using 18F-FDG-PET/CT, sarcoid-like reaction regressed in 11 (79%) patients and did not regress in 3 (21%) patients. The time interval between the appearance of sarcoid-like reaction and its regression was 3–80 months (median, 8.5 months).

Conclusion

After the treatment of malignancies, benign sarcoid-like reaction was rarely observed during follow-up. Although sarcoid-like reaction appeared a long time after the treatment of malignancies, it frequently and spontaneously regressed in a relatively short period of time.

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Authors and Affiliations

  1. Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan

    Yo Kaneko, Hiroki Kato & Masayuki Matsuo

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  1. Yo Kaneko
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  2. Hiroki Kato
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  3. Masayuki Matsuo
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Correspondence to Hiroki Kato.

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Kaneko, Y., Kato, H. & Matsuo, M. Hilar and mediastinal sarcoid-like reaction after the treatment of malignant tumors: imaging features and natural course on 18F-FDG-PET/CT. Jpn J Radiol 37, 88–94 (2019). https://doi.org/10.1007/s11604-018-0786-4

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  • DOI: https://doi.org/10.1007/s11604-018-0786-4

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