A case of tongue carcinoma with enlarged cervical lymph nodes presumed to be sarcoid reaction

A sarcoid reaction refers to the formation of noncaseating epithelioid cell granulomas in the regional lymph nodes of malignant tumors in the absence of systemic symptoms or signs of sarcoidosis.We report a case of tongue carcinoma with enlarged cervical lymph nodes presumed to be a sarcoid reaction.A 79-yearold man was referred to our department due to awareness of a painful mass in the left inferior surface of the tongue.Contrast enhanced CT and MR images showed relatively clear lesions in the inferior area of the tongue and showed enlarged cervical nodes on the right side.A fine needle aspiration cytology showed no obvious malignant findings in a cervical lymph node.Based on a diagnosis of cT2N0M0, a partial tongue resection was performed.The histopathological diagnosis was squamous cell carcinoma.As postoperative CT showed worsening of right cervical lymph node enlargement and FDG-PET/CT showed significant uptake of FDG in the same area.A core needle biopsy was performed.Histopathological examination revealed non-caseating epithelioid cell granuloma.The differential diagnosis of tuberculosis and non-tuberculous mycobacterial disease were excluded through blood tests.As there was no general condition or signs of sarcoidosis, the final diagnosis was presumed to be sarcoid reaction associated with tongue carcinoma.