PMC6900677_01
(Left) FDG PET showing highly avid lymph nodes. Right suprahilar lymph node with
standardized uptake value (SUV) maximum of 25.4 and paratracheal lymph node with
SUV of 18.6. (Right) CT scan of chest showing subcarinal and right hilar
lymphadenopathy; the right main stem bronchus shown in mediastinal window.
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PMC6900677_01_10.1177_2324709619892724-fig1.jpg
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Hence, a computed tomography scan of thorax was ordered, which revealed an incidental 2-cm left breast mass, diffuse lymphadenopathy, and a right hilar mass encasing the right main stem bronchus (Figure 1).
(Top left) Hematoxylin and eosin stain showing noncaseating granulomas at 200x
magnification from the peribronchial lymph node (station 10R). Arrow points to
area of granuloma. (Top right) Hematoxylin and eosin stain showing noncaseating
granulomas from the peribronchial lymph node (station 10R). 400x magnification
showing epithelioid histiocytes with footprint-shaped nuclei and abundant
eosinophilic cytoplasm. (Bottom left) Hematoxylin and eosin stain prepared in
CytoLyt showing noncaseating granulomas at 200x magnification from the
subcarinal lymph node (station 7). Arrow points to area of granuloma. (Bottom
right) Hematoxylin and eosin stain that was prepared in CytoLyt showing
noncaseating granulomas from the subcarinal lymph node (station 10R). 400x
magnification showing epithelioid histiocytes with footprint-shaped nuclei.
10.1177_2324709619892724-fig2.jpg
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Other notable lymphadenopathy was noted in the lower paratracheal area with SUV of 12.3 and right anterior mediastinal adenopathy with SUV of 6.6 (Figure 2). Cytopathology was evaluated at the peribronchial lymph node (station 10R) and subcarinal lymph node (station 7), which were all of samples were consistent with noncaseating granuloma with giant cell reaction (Figure 2).