PT  - JOURNAL ARTICLE
AU  - Carlos González-Cruz
AU  - Domingo Bodet
AU  - Eva Muñoz-Couselo
AU  - Vicente García-Patos
TI  - Mediastinal FDG-positive lymph nodes simulating melanoma progression: drug-induced sarcoidosis like/lymphadenopathy related to ipilimumab
AID  - 10.1136/bcr-2020-237310
DP  - 2021 Jan 01
TA  - BMJ Case Reports
PG  - e237310
VI  - 14
IP  - 1
4099  - http://casereports.bmj.com/content/14/1/e237310.short
4100  - http://casereports.bmj.com/content/14/1/e237310.full
SO  - BMJ Case Reports2021 Jan 01; 14
AB  - Drug-induced sarcoidosis-like reactions (DISRs) are systemic granulomatous diseases that develop in the context of a new drug onset. Ipilimumab is an immune checkpoint inhibitor (ICI) approved for the treatment of advanced melanoma which has been associated with DISR. Differential diagnosis between tumour progression and DISR by positron emission tomography/computed tomography (PET/CT) in patients treated with an ICI can be a challenge. A 31-year-old woman was diagnosed with a stage IIIB melanoma in her back. Ipilimumab 10 mg/kg was initiated. After 1 month of finishing the treatment a routine, PET/CT showed multiple enlarged mediastinal and hilar lymph nodes FDG-positive. A transbronchial biopsy showed sarcoid-like granulomatous infiltration which favoured the diagnosis of DISR related to ipilimumab. The patient remained asymptomatic and lymphadenopathy regressed progressively after 11 months. Our work highlights the importance of differentiating DISR from tumour progression, before unnecessary changes in therapeutic strategies. PET/CT is a useful diagnostic tool for its follow-up.