Abstract
We report the first case of sarcoidosis-like reaction in a patient treated by anti-PD-L1 for a breast cancer. A 69-year-old woman presented with a histologically confirmed lung metastasis of a triple negative breast cancer. She was treated by nab-paclitaxel plus anti-PD-L1 in first line. After 2 months, a dramatic lung response was noticed but an involvement of mediastinal lymph nodes appeared. Endoscopic ultrasound-guided fine-needle aspiration of these lymph nodes revealed multiple epitheloid granulomas without caseating necrosis in favour of a sarcoidosis-like reaction. The patient remained free of symptom and in complete lung response on anti-PD-L1 treatment as a maintenance therapy.
Keywords:
anti-PD-L1; immune checkpoint inhibitor; sarcoidosis-like reaction; triple negative breast cancer.
© 2019 Wiley Periodicals, Inc.
MeSH terms
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Aged
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Albumins / administration & dosage
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Antibodies, Monoclonal, Humanized / administration & dosage
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Antibodies, Monoclonal, Humanized / adverse effects*
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Antineoplastic Combined Chemotherapy Protocols / adverse effects*
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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B7-H1 Antigen / antagonists & inhibitors
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Biopsy, Fine-Needle
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Female
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Humans
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Lung Neoplasms / diagnostic imaging
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Lung Neoplasms / drug therapy
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Lung Neoplasms / secondary
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Lymph Nodes / drug effects*
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Lymph Nodes / pathology
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Lymphatic Diseases / chemically induced
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Molecular Targeted Therapy
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Paclitaxel / administration & dosage
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Sarcoidosis / chemically induced*
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Triple Negative Breast Neoplasms / drug therapy*
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Triple Negative Breast Neoplasms / pathology
Substances
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130-nm albumin-bound paclitaxel
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Albumins
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Antibodies, Monoclonal, Humanized
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B7-H1 Antigen
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CD274 protein, human
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atezolizumab
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Paclitaxel