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Kim, Lim, Kim, Hwang, Park, Jang, Min, Lee, Hwang, Lee, and Kim: A Case of Thyroid Cancer Combined with Pulmonary Sarcoidosis
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(1): 52-56.

Published online: 31 July 2008

DOI: https://doi.org/10.4046/trd.2008.65.1.52

A Case of Thyroid Cancer Combined with Pulmonary Sarcoidosis

Su Jin Kim, M.D.1, Tae Kyung Lim, M.D.1, Changhwan Kim, M.D.1, Yong Il Hwang, M.D.1, Sunghoon Park, M.D.1, Seung Hun Jang, M.D.1, Kwangseon Min, M.D.2, In Jae Lee, M.D.3, Hee Sung Hwang, M.D.4, Jae Woong Lee, M.D.5, Dong-Gyu Kim, M.D.1

1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

2Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

3Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

4Department of Nuclear Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

5Department of Thoracic and Cardiovascular Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

Address for correspondence: Dong-Gyu Kim, M.D. Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University College of Medicine, 896, Pyeongchon-dong, Dongan-gu 431-070, Korea. Phone: 82-31-380-3719, Fax: 82-31-380-3973, dongyu@hallym.ac.kr

Received 9 May 2008       Accepted 17 June 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Sarcoidosis is a systemic granulomatous disease that primarily affects the lung and lymphatic system of the body. Since Brincker first noted a statistically significant increase of malignant tumors among sarcoidosis patients, there have been several reports on simultaneously developed sarcoidosis and malignancy. A 30-year-old man was admitted to our hospital because of multiple enlarged mediastinal lymph nodes. The patient had been well until approximately 10 days before admission, when he developed a cough. Chest X-ray and computed tomography (CT) of the chest that were performed at the outpatient department revealed multiple enlarged mediastinal lymph nodes. Cervical lymph node biopsy revealed both non-caseating granuloma and metastatic papillary carcinoma, whereas the mediastinal lymph node showed only non-caseating granuloma. The thyroid gland surgical specimen showed papillary carcinoma. We report here on a case of a 30-year-old man who had sarcoidosis and thyroid cancer, and we include a review of the literature.

Keywords: Sarcoidosis, Thyroid cancer

Figures and Tables

Figure 1
Chest X-ray shows bilateral hilar lymphadenopathy.
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Figure 2
Chest CT shows bilateral hilar and mediastinal lymphadenopathy and wide spread small nodules with a bronchovascular distribution in both lungs.
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Figure 3
(A) Multiple well-formed small non-caseating granulomas are observed in cervical lymph nodes (short arrows). A multinucleated giant cell is also seen (arrow head) (H&E stain, ×100). (B) Metastatic papillary carcinoma from thyroid is seen in lymph nodes (long arrows) (H&E stain, ×100).
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Figure 4
18F-FDG PET/CT reveals multiple lymphadenopathy with FDG hypermetabolism in bilateral hilar & mediastinal (A, D), right supraclavicular (B, arrow) and mesenteric areas (E). A thyroid nodule located in left lower thyroid gland shows no demonstrable FDG hypermetabolism (B, arrow head). Perithyroidal lymph node with mild FDG hyperactivity (C, arrow) has proved a metastatic and sarcoidosis node. Small peribronchovascular pulmonary nodules are seen in right upper and right lower lobes with faint increased FDG uptake (D).
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Figure 5
Thyroid gland surgical specimen reveals papillary carcinoma (H&E stain, ×100).
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Figure 6
Multiple non-caseating granulomas (arrow) and metastatic papillary carcinoma from thyroid (asterisk) are observed in a perithyroidal lymph node (H&E stain, ×40).
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References

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