Sarcoid-Like Reaction Mimicking Disease Progression Associated with Nivolumab in a Case with Malignant Mesothelioma: Is There a Solution for This Dilemma?
Sarcoid like reaction is an interesting entity in cases treated by checkpoint inhibitor treatment and suggests a good response to therapy. Here a case with granulomatous reaction has been reported in a case with malignant mesothelioma treated by nivolumab. This entity may simulate disease progression by imaging modalities especially in PET/CT.
1. Hiraki T, Hatanaka M, Arimura A, Kawahira H, Kirishima M, Kitazono M, et al. Granulomatous/sarcoid-like reactions in the setting of programmed cell death-1 inhibition: a potential mimic of disease recurrence. J Cutan Pathol 2020;47:154-60.
2. Hersey P, Karikos D, Shannon K, Van Hal S, Carr U, Crotty A, et al. Immunotherapy-induced sarcoidosis in patients with melanoma treated with PD-1 checkpoint inhibitors: Case series and immunophenotypic analysis. Int J Rheum Dis 2017:20;1277–85.
3. Tetzlaff MT, Nelson KC, Diab A, Staerkel GA, Nagarajan P, Torres-Cabala CA, et al. Granulomatous/sarcoid-like lesions associated with checkpoint inhibitors: a marker of therapy response in a subset of melanoma patients. J Immunother Cancer 2018;6:14.
4. van Baar MLM, Guminski AD, Ferguson PM, Martin LK. Pembrolizumab for cutaneous squamous cell carcinoma: Report of a case of inoperable squamous cell carcinoma with complete response to pembrolizumab complicated by granulomatous inflammation. JAAD Case Rep 2019;5:491-4.
5. Li Z, Graf N, Herrmann K, Jünger A, Aichler M, Feuchtinger A, et al. FLT-PET is superior to FDG-PET for veryearly response prediction in NPM-ALK-positive lymphoma treated with targeted therapy. Cancer Res 2012;72:5014–24.