title: [Mediastinal Nonseminomatous Germ Cell Tumor with Sarcoid-like Reaction in the Regional Lymph Nodes].
abstract: A 26-year-old man was admitted because of an abnormal shadow on a chest roentgenogram. Computed tomography(CT) revealed a very large tumor in the anterior mediastinum and bilateral mediastinal lymphadenopathy. Examination of a CT-guided biopsy specimen revealed a yolk-sac tumor. The patient received 4 courses of bleomycin, etoposide, and cisplatin chemotherapy. After chemotherapy, the tumor was markedly reduced in size, but the lymphadenopathy remained. The patient underwent thoracoscopic biopsy of the mediastinal lymph nodes. Sarcoid nodules were found in all the biopsied nodes, and the lymphadenopathy was thought to be a sarcoid-like reaction associated with the germ cell tumor. Resection of the residual tumor was performed according to the treatment algorithm of the International Germ Cell Cancer Collaborative Group. There were no viable tumor cells in the resected tissue. The patient is free of recurrence and without any sign of generalized sarcoidosis 3 years after the surgery.
authors.affiliation: Department of General Thoracic Surgery, Nihonkai General Hospital, Sakata, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Hamada
authors.forename: Naoki
authors.initials: N
authors.lastname: Kanauchi
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Suzuki
authors.forename: Hikaru
authors.initials: H
authors.lastname: Watanabe
authors.forename: Isamu
authors.initials: I
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008479:Mediastinal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D064847:Multimodal Imaging; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000601:surgery; D049268:Positron-Emission Tomography; D013736:Testicular Neoplasms; D014057:Tomography, X-Ray Computed