Search

Although the association between seminoma and sarcoidosis or a sarcoid-like reaction has been well recognized, a paradoxical case during chemotherapy for seminoma has not been reported. We report the first case of a sarcoid-like reaction that developed paradoxically during successful chemotherapy for recurrent seminoma. A 36-year-old Japanese man had recurrent seminoma in abdominal lymph nodes four years after left orchiectomy. Chemotherapy consisting of bleomycin, etoposide and cisplatin had reduced the abdominal mass, but mediastinal and bilateral hilar lymphadenopathy newly appeared. Surgical biopsy of the mediastinal lymph nodes and left nephrectomy and retroperitoneal lymphadenectomy revealed noncaseating granulomas only in mediastinal lymph nodes and confirmed complete remission of seminoma. Nine months later the thoracic lymphadenopathy had resolved spontaneously.

A 60-year-old woman was suffering from acute onset and progressive respiratory distress. Her radiographic findings showed bilateral volume loss in her lower lobes and consolidation predominantly distributed in peribronchovascular areas. The biopsied specimens performed by video-assisted thoracoscopic surgery revealed prominent fibromyxoid connective tissue within the terminal respiratory bronchioles and the alveolar spaces along the airways without marked interstitial fibrosis. No relevant cause was determined, and she was diagnosed as having idiopathic BOOP. Although her clinical course was fulminant with a poor reaction to steroid therapy, simultaneous administration of cyclosporin A and corticosteroid elicited a rapid improvement. This case report presents the effectiveness of cyclosporin A in the treatment of progressive BOOP.

We encountered a 73-year-old man with acute pulmonary embolism (PE) and Baker's cyst. Venography revealed that the right popliteal vein was compressed by Baker's cyst and deep venous thrombosis (DVT) had developed. DVT associated with Baker's cyst is rather common and these two conditions are thought to be causally related. Baker's cyst is the most frequent mass lesion in the popliteal region. We suggest that Baker's cyst is a risk factor for PE as well as surgery and trauma.