胃癌伴结节病1例报道并相关文献复习

目的探讨恶性肿瘤合并结节病的临床表现、诊断及两者之间的关系。方法报道1例胃癌合并结节病病例,并复习有关文献。结果结节病表现无特异性,诊断困难,误诊率高,非侵袭性的检查方法包括18F-FDG-PET-CT难以区分结节病、恶性肿瘤及癌伴引流区淋巴结结节病样肉芽肿反应(SGR),活检仍是必须的,而18F-FMT-PET(18F标记甲基酪氨酸-PET)有助于结节病与恶性肿瘤的鉴别。恶性肿瘤合并结节病国内尚无报道,两者之间是否存在某种关联,尚需进一步研究。结论该病例说明对明确诊断为恶性肿瘤的患者,影像学提示淋巴结肿大,需考虑有合并结节病可能。

A case of gastric cancer associated with systemic sarcoidosis

Aim To investigate the clinical presentation,diagnosis of cancer associated with sarcoidosis,and the relationship between them.Methods In this article,we described a case of gastric cancer associated with systemic sarcoidosis,and the correlated literatures were reviewed.Results Sarcoidosis had no specific clinical presentation,was hard to diagnose and had a high misdiagnosis rate.Clinicians needed novel non invasive diagnostic methods to differentiate cancer from benign sarcoid reactions.The 18-Fuorodeoxyglucose（18-FDG） PET-CT-scan failed in this indication,but the adjunction of a[3-（18）F]-alpha-methyltyrosine（（18）F-FMT）PET-scan could be useful.Biopsies was still necessary in most of the cases.Relationships between Sarcoidosis and cancer had been suspected for a long time.Nevertheless,few evidence had been reported until recently,and further study was needed.Conclusion This article suggest that the possibility of systemic sarcoidosis should be considered in cases with established cancer and newly disclosed radiographic findings.