FDG PET for esophageal cancer complicated by sarcoidosis mimicking mediastinal and hilar lymph node metastases: two case reports.

This report documents 2 cases of esophageal cancer complicated by sarcoidosis mimicking mediastinal lymph node metastases on F-18 fluorodeoxyglucose positron emission tomography (FDG PET) for staging of the cancer. In both cases, FDG PET demonstrated intense uptake in the swollen mediastinal and bilateral hilar lymph nodes. In 1 case, FDG PET showed intense uptake in the primary esophageal cancer. In another case, FDG PET showed no definite intense uptake in the primary esophageal cancer. The histopathology of the resected mediastinal and hilar lymph nodes demonstrated no malignant cells but sarcoid lesions such as noncaseating granuloma. Therefore, sarcoidosis should be considered when FDG PET shows intense FDG uptake in nonregional swollen lymph nodes, although the incidence of esophageal cancer complicated by sarcoidosis is rare.