Mediastinal FDG-positive lymph nodes simulating melanoma progression: drug-induced sarcoidosis like/lymphadenopathy related to ipilimumab.
Adult
Back
Biopsy
Diagnosis, Differential
Disease Progression
Female
Fluorodeoxyglucose F18
Granuloma
/ chemically induced
Humans
Immune Checkpoint Inhibitors
/ adverse effects
Ipilimumab
/ adverse effects
Lymph Nodes
/ diagnostic imaging
Lymphadenopathy
/ chemically induced
Mediastinum
Melanoma
/ diagnostic imaging
Neoplasm Staging
Positron Emission Tomography Computed Tomography
Radiopharmaceuticals
Skin Neoplasms
/ drug therapy
dermatology
drugs and medicines
immunological products and vaccines
radiology (diagnostics)
skin cancer
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
28 Jan 2021
28 Jan 2021
Historique:
entrez:
29
1
2021
pubmed:
30
1
2021
medline:
4
3
2021
Statut:
epublish
Résumé
Drug-induced sarcoidosis-like reactions (DISRs) are systemic granulomatous diseases that develop in the context of a new drug onset. Ipilimumab is an immune checkpoint inhibitor (ICI) approved for the treatment of advanced melanoma which has been associated with DISR. Differential diagnosis between tumour progression and DISR by positron emission tomography/computed tomography (PET/CT) in patients treated with an ICI can be a challenge. A 31-year-old woman was diagnosed with a stage IIIB melanoma in her back. Ipilimumab 10 mg/kg was initiated. After 1 month of finishing the treatment a routine, PET/CT showed multiple enlarged mediastinal and hilar lymph nodes FDG-positive. A transbronchial biopsy showed sarcoid-like granulomatous infiltration which favoured the diagnosis of DISR related to ipilimumab. The patient remained asymptomatic and lymphadenopathy regressed progressively after 11 months. Our work highlights the importance of differentiating DISR from tumour progression, before unnecessary changes in therapeutic strategies. PET/CT is a useful diagnostic tool for its follow-up.
Identifiants
pubmed: 33509865
pii: 14/1/e237310
doi: 10.1136/bcr-2020-237310
pmc: PMC7845685
pii:
doi:
Substances chimiques
Immune Checkpoint Inhibitors
0
Ipilimumab
0
Radiopharmaceuticals
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Melanoma Res. 2018 Jun;28(3):230-236
pubmed: 29485531
J Oncol Pharm Pract. 2017 Dec;23(8):620-624
pubmed: 27590328
Case Rep Oncol. 2017 Nov 27;10(3):1070-1075
pubmed: 29515398
PLoS One. 2016 Jul 29;11(7):e0160221
pubmed: 27472273
Am J Clin Oncol. 2016 Feb;39(1):98-106
pubmed: 26558876
AJR Am J Roentgenol. 2011 Dec;197(6):W992-W1000
pubmed: 22109345
N Engl J Med. 2016 Nov 10;375(19):1845-1855
pubmed: 27717298
J Immunother Cancer. 2018 Feb 12;6(1):14
pubmed: 29433571
Oncology (Williston Park). 2010 Dec;24(14):1280-8
pubmed: 21294471
J Immunother Cancer. 2018 Jun 13;6(1):52
pubmed: 29898781
Chest. 2018 Sep;154(3):664-677
pubmed: 29698718