title: Unilateral pulmonary hilar tumor mass: is it always lung cancer?
abstract: Sarcoidosis is a multisystem inflammatory disease of unknown etiology, characterized by noncaseating epithelioid cell granulomas. In sarcoidosis, the most common radiological findings are mediastinal and bilateral hilar lymph node enlargement. We present a case of sarcoidosis with a rare radiological aspect of pulmonary hilar tumor mass.A 54-year-old female patient, active smoker (40 packs/year), with a history of cutaneous lupus, was admitted in our institute for progressive dyspnea and dry cough. At admission physical examination and laboratory tests were normal. Pulmonary function tests diagnosed an obstructive syndrome. Chest X-ray showed a tumor mass of the right pulmonary hilum. Transbronchial biopsy was nondiagnostic. HRCT-scan showed a tumor mass in the right hilum, which raised the suspicion of a lung cancer. PET-CT scan revealed a high metabolic activity of the tumor mass and of a paratracheal right lymphadenopathy. Lymph node biopsy by mediastinoscopy showed noncaseating epithelioid-cell granulomas, sustaining the diagnosis of sarcoidosis. The outcome was favorable, with spontaneous remission without treatment, but with a relapse that responded after systemic corticotherapy.In conclusion, even if a tumor mass in the pulmonary hilum is highly suggestive of lung cancer, a positive diagnosis should be made only after histological examination, because other benign conditions, like sarcoidosis, could have such an aspect.
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; "Marius Nasta" Institute of Pneumology, Bucharest, Romania.
authors.forename: Claudia Lucia
authors.initials: CL
authors.lastname: Toma
authors.forename: Stefan
authors.initials: S
authors.lastname: Dumitrache-Rujinski
authors.forename: Ionela Nicoleta
authors.initials: IN
authors.lastname: Belaconi
authors.forename: Bianca
authors.initials: B
authors.lastname: Paraschiv
authors.forename: Mihai
authors.initials: M
authors.lastname: Alexe
authors.forename: Aneta
authors.initials: A
authors.lastname: Serbescu
authors.forename: Diana
authors.initials: D
authors.lastname: Leonte
authors.forename: Miron Alexandru
authors.initials: MA
authors.lastname: Bogdan
keywords: lung cancer; sarcoidosis; tumor mass
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