title: Surgical results of lung cancer with sarcoid reaction in regional lymph nodes.
abstract: BACKGROUND
  There have been few reports of sarcoid reaction in the regional lymph nodes associated with lung cancer. The purpose of this study was to analyze the surgical results of lung cancer with sarcoid reaction.
  
  
  METHODS
  Of 1733 lung cancer patients undergoing surgical treatment in our institute from 1990 to 2004, we reviewed 22 patients (1.3%) with sarcoid reaction in the regional lymph nodes of lung cancer.
  
  
  RESULTS
  On pre-operative computed tomography (CT), mediastinal lymph node swelling was detected in 19 patients (86%) as clinical N3 disease (c-N3) in six or as c-N2 in 13, while three patients were classified as c-N0. To these 19 patients, lymph node status was histologically checked by mediastinoscopy in four patients, sternotomy approach in two and open mini-thoracotomy in 13. Because the sampling-biopsy nodes showed no tumor metastasis, radical surgery was promptly performed. However, four patients (18%) were finally judged to have pathological lymph node positive disease. Five patients were in pathological stage (p-stage) IA, nine in p-stage IB, five in p-stage IIB, two in p-stage IIIA, and one in stage IIIB. The overall 3-, and 5-year survival rates of these patients were 85.2 and 77.7%, respectively, with no significant difference compared to those of the remaining patients without sarcoid reaction.
  
  
  CONCLUSIONS
  Because lung cancer patients with sarcoid reaction in the regional lymph nodes frequently show mediastinal lymph node swelling on CT, radical resection should be performed after confirming the node status by appropriate sampling biopsy. It seems that surgical results of lung cancers with sarcoid reaction in the regional nodes are not prognostically different from those without sarcoid reaction.
authors.affiliation: Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan. higasiyama-ma@mc.pref.osaka.jp.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tomimaru
authors.forename: Masahiko
authors.initials: M
authors.lastname: Higashiyama
authors.forename: Jiro
authors.initials: J
authors.lastname: Okami
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Oda
authors.forename: Koji
authors.initials: K
authors.lastname: Takami
authors.forename: Ken
authors.initials: K
authors.lastname: Kodama
authors.forename: Yoshitane
authors.initials: Y
authors.lastname: Tsukamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000150:complications* / Q000473:pathology; D016019:Survival Analysis