May sarcoidal reaction and malignant features coexist in regional lymph nodes of non-small cell lung cancer patients?

In the study of Steinfort et al., as well as in previous studies, no cases of co-involvement of malignant features and sarcoidal reactions were seen in non-small cell lung cancer patients undergoing mediastinal staging, leading the authors to state that non-necrotizing granulomas revealed by EBUS-TBNA should serve to indicate the absence of lymph node metastases. We report on a case of stage IIIA pulmonary adenocarcinoma in which TBNA of a subcarinal node showed the presence of both neoplastic cells and non-necrotizing granulomas. (C) 2009 Published by Elsevier Ireland Ltd.