Suture granuloma simulating lung neoplasm occurring after segmentectomy.

Fink, Gershon; Herskovitz, Pearl; Nili, M; Hadar, Herzlia; Rothem, A.; Spitzer, Simon

doi:10.1136/thx.48.4.405

Cited by 19 publications

(14 citation statements)

References 9 publications

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“…According to our review of the literature, only four surgically resected cases [1][2][3][4] have been reported up to the present, as summarized in Table 1. Among them, two cases manifested as hemoptysis after a surgical procedure for pneumothorax, and they were preoperatively diagnosed as benign granuloma: tuberculoma in case 1 and suture granuloma in case 3.…”

Section: Discussionmentioning

confidence: 98%

Pulmonary suture abscess with false-positive 18F-fluorodeoxyglucose positron emission scan mimicking lung cancer recurrence

Iwasaki

Nakagawa

Katsura

et al. 2006

Jpn J Thorac Cardiovasc Surg

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We present the case of a 57-year-old woman with pulmonary suture abscess. She had undergone right S3 segmentectomy for early lung adenocarcinoma 7 years before and right breast-conserving surgery for invasive ductal carcinoma 5 months previously, followed by irradiation plus endocrine therapy. Chest radiography and computed tomography revealed an irregular mass (3.5 cm in diameter) between the residual S1 segment and the middle lobe, neighboring the staple line of the segmentectomy. 18F-fluorodeoxyglucose uptake into the mass increased, seen by positron emission scans. Therefore, we could not rule out the possibility of local recurrence of lung cancer and resected it. Pathologically and microbiologically, the mass was a suture abscess arising around the nylon suture of the previous segmentectomy. This lesion was the result of a foreign-body reaction, as confirmed by polarized microscopy. Moreover, titanium staples at the segmentectomy and breast-conserving surgery may also have contributed to this condition.

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Section: Discussionmentioning

confidence: 98%

Pulmonary suture abscess with false-positive 18F-fluorodeoxyglucose positron emission scan mimicking lung cancer recurrence

Iwasaki

Nakagawa

Katsura

et al. 2006

Jpn J Thorac Cardiovasc Surg

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“…Such lesions may appear between a few months and as much as 10 years following surgery [1]. Suture granulomas that mimic malignancy have been described following surgery of the lung [2], colon [3], oesophagus [4], bladder [5], head and neck [6], omentum [7], breast [8] and hernia repair [1]. Foreign bodies which remain following paediatric herniotomy may migrate along the obliterated umbilical artery and create a pseudotumour that extends from the external inguinal ring to the umbilicus.…”

Section: Discussionmentioning

confidence: 98%

The role of ultrasound in the diagnosis of stitch granulomas following paediatric herniotomy

Nagar

Kessler

Graif

1999

Pediatric Radiology

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“…Pulmonary granuloma is caused by inflammation; infection of bacteria, fungi, and human herpesvirus-8 [3]; and foreign bodies. Sutures and staplers also cause granuloma after lung resection [4,5], in particular, stapler granulomas due to foreign body reaction [4,6]. Although Munteanu et al first reported suture granuloma by PGA suture [7], pulmonary granulomas caused by a PGA sheet have never been reported.…”

Section: Discussionmentioning

confidence: 99%

Two cases of granuloma mimicking local recurrence after pulmonary segmentectomy

Okazaki

Sano

Mori

et al. 2020

J Cardiothorac Surg

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Background: Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT is the most sensitive non-invasive imaging method for the detection of tumor metastasis and recurrence, but sometimes reveals false-positive results. Herein, we report two cases of false-positive results on PET/CT scans along with elevated serum carcinoembryonic antigen (CEA) levels, mimicking local recurrence after pulmonary segmentectomy. Case presentation: Case 1; A 75-year-old woman underwent thoracoscopic left basal segmentectomy for primary lung cancer. Follow-up at 6 months after the surgery revealed serum CEA level elevation and chest CT showed a nodule measuring 25 × 22 mm in the residual left lower lobe. PET/CT revealed FDG uptake in the nodule diagnosed as local recurrence of lung cancer, and the patient underwent partial resection of the nodule. Microscopic examination of the resected specimen revealed granuloma caused by polyglycolic acid (PGA) sheet. Case 2; A 58-year-old man underwent VATS right S1 segmentectomy for lung metastasis from rectal carcinoma. Serum CEA levels gradually increased after surgery, and PET/CT revealed FDG uptake in the stump diagnosed as local recurrence of the lung metastasis. The patient underwent completion lobectomy 6 months after the segmentectomy, and the pathology of the resected specimen revealed an inflammatory granuloma caused by PGA suture. Conclusions: Although suture and stapler granulomas have been reported, granuloma caused by PGA sheets has never been reported. Postoperative recurrence of lung cancer should be diagnosed with not only PET/CT scans and serum tumor markers but also pathological findings, to avoid unnecessary treatment such as chemotherapy, radiation, and difficult reoperation.

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Suture granuloma simulating lung neoplasm occurring after segmentectomy.

Cited by 19 publications

References 9 publications

Pulmonary suture abscess with false-positive 18F-fluorodeoxyglucose positron emission scan mimicking lung cancer recurrence

Pulmonary suture abscess with false-positive 18F-fluorodeoxyglucose positron emission scan mimicking lung cancer recurrence

The role of ultrasound in the diagnosis of stitch granulomas following paediatric herniotomy

Two cases of granuloma mimicking local recurrence after pulmonary segmentectomy

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