{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T18:48:17Z","timestamp":1780598897868,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In patients with extrathoracic malignancies (ETM), granulomatous lymph adenopathy called sarcoid\u2010like reactions (SLR) can be seen in the regional or draining lymph nodes. We hypothesized that SLR may be a sign of imminent metastasis and investigated the clinical course and rate of recurrence in patients with ETM and granulomatous mediastinal lymphadenopathy (MLN).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective observational study, we reviewed the medical files of patients with known ETM and who underwent EBUS\u2010TBNA for initial staging or detection of recurrence from 2011 to 2023. Patients with granulomatous MLN were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010one patients (29 female) enrolled in the study. Breast and colorectal carcinomas were the most common malignancies. A total of 81 lymph nodes were sampled. The final diagnosis of patients was five sarcoidosis, one tuberculosis, one second primary, one drug reaction, and 33 SLR. Among patients with SLR, in one patient lymph nodes progressed during the follow\u2010up and were accepted as false\u2010negative without confirmatory biopsy. The negative predictive value (NPV) of granulomatous MLN for metastasis was 97.05%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Granulomatous MLN may be due to tuberculosis, drug reaction, sarcoidosis, or SLR in patients with ETM. SLR has a high NPV in patients with ETM. Follow\u2010up imaging rather than confirmatory biopsy is reasonable in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dc.25337","type":"journal-article","created":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T05:14:14Z","timestamp":1714540454000},"page":"475-479","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Importance of mediastinal granulomatous\/sarcoid\u2010like lymphadenopathy in extrathoracic malignancies"],"prefix":"10.1002","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1645-7761","authenticated-orcid":false,"given":"Serhat","family":"Erol","sequence":"first","affiliation":[{"name":"Department of Chest Diseases Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asl\u0131han Gurun","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8141-2311","authenticated-orcid":false,"given":"Fatma","family":"Arslan","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirac","family":"Oz","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deniz Do\u011fan","family":"Mulazimoglu","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozlem","family":"Is\u0131k","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aydin","family":"Ciledag","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koray","family":"Ceyhan","sequence":"additional","affiliation":[{"name":"Department of Pathology Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demet","family":"Karnak","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"Sen","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gokhan","family":"Celik","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akin","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"Savas","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases Ankara University School of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.5578\/tt.70045"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3906\/sag\u20101407\u2010113"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408\u2010022\u201000584\u20105"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/cup.13569"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202002\u20100251ST"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3960\/jslrt.52.1"},{"issue":"2","key":"e_1_2_9_8_1","first-page":"149","article-title":"ATS\/ERS\/WASOG statement on sarcoidosis. 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