title: Sarcoid-reaction mimicking metastatic malignant hepatopancreatobiliary tumors: report of two cases and review of the literature.
abstract: BACKGROUND
  Sarcoidosis is a multisystem chronic granulomatous disease found predominantly in the lungs and lymph nodes. Its pathologic hallmark is the presence of systemic non-caseating granulomas; however, a variation of this disease known as "sarcoid-like reaction" has been described in patients with underlying cancer.
  
  
  METHODS
  Sarcoid-like reactions in patients with hepatopancreatobiliary (HPB) tumors are rare findings, with only 15 cases having been reported in the English language literature. These reactions can be found in local lymph nodes or in distant organs, and when present in patients with cancer, they can mimic metastatic disease on imaging, potentially resulting in incorrect cancer staging and management.
  
  
  CONCLUSIONS
  We describe two cases of patients with HPB tumors who had distant organ disease on cross-sectional imaging suspicious for metastases, which on further workup were found to be sarcoid-like reactions. We also discuss malignancy-induced sarcoid-like reactions and provide a review of the literature of sarcoid-like reactions in the setting of HPB tumors.
authors.affiliation: Department of Surgery, Thomas Jefferson University, Jefferson Pancreas, Biliary and Related Cancer Center, Philadelphia, PA 19107, USA.
authors.forename: Zhi Ven
authors.initials: ZV
authors.lastname: Fong
authors.forename: Joshua
authors.initials: J
authors.lastname: Wong
authors.forename: Warren R
authors.initials: WR
authors.lastname: Maley
authors.forename: Nora
authors.initials: N
authors.lastname: Sandorfi
authors.forename: Jordan M
authors.initials: JM
authors.lastname: Winter
authors.forename: Leonidas G
authors.initials: LG
authors.lastname: Koniaris
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Sauter
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Yeo
authors.forename: Harish
authors.initials: H
authors.lastname: Lavu
mesh_terms: D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000556:secondary; D049268:Positron-Emission Tomography; D012507:Sarcoidosis / Q000175:diagnosis*; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology; D013156:Splenectomy; D013158:Splenic Diseases / Q000175:diagnosis*