Background:
Sarcoidosis is usually diagnosed by ruling out other granulomatous inflammatory diseases. Rarely,
it may be suspected with a pathological examination after surgical intervention for another disease. The sarcoid
reaction is noninfectious granulomatous lymphadenitis which can occur at nodes draining a neoplasm. We
demonstrated granulomatous lesions masquerading metastasis by Positron Emission Tomography/Computed
Tomography (PET/CT) in endometrial cancer. We presented two cases of endometrial cancer with sarcoidosis and
sarcoid-like reactions because of their challenging clinical and radiological findings.
Cases:
In case 1, there was diffuse granulomatous inflammation (no metastasis) in lymph nodes (n=92) and giant
cells containing calcifications (Schaumann bodies). In case 2, PET/CT revealed hypermetabolism with malignancy
suspicion in the pelvic lymph nodes (maximum standardized uptake value= 13) and pathological evaluation
reported a 4.5 cm tumor within the uterine cavity without any nodal metastasis.
Results:
PET/CT has no role in the evaluation of differential diagnosis between granulomatous lymphadenitis and
metastatic disease.
Conclusions:
Granulomatous lesions might mimic the metastasis of coexisting malignant diseases.
Potential Applications of PET/CT/MR Imaging in Inflammatory Diseases