Tuberculous and non-tuberculous granulomatous lymphadenitis in patients receiving imatinib mesylate (glivec) for metastatic gastrointestinal stromal tumor.

摘要: Background: Imatinib mesylate (IM) is the standard treatment for BCR-ABL-positive chronic myelogenous leukemia (CML) and first-line adjuvant palliative metastatic inoperable gastrointestinal stromal tumor (GIST). IM not known to be associated with an increased risk development of granulomatous diseases. Methods: We describe our experience 2 patients (42 62 years age) who developed disease during GIST. Results: Mean duration was 12 (range 8-16) months. Enlarged lymph nodes metabolism on FDG-PET-CT examination were detected resected. Affected sites supraclavicular (1) subcarinal/mediastinal nodes. Histological revealed caseating non-caseating granulomas suggestive tuberculosis sarcoidosis, respectively. Mycobacterium by PCR in 1 patient then successfully treated anti-tuberculous agents. The other had negative sputum test acid-fast bacilli PCR-DNA-analysis M. mycobacteria. He received no therapy evidence progressive lymphadenopathy or new lung lesions follow-up. Conclusion: Our observations underline necessity obtain biopsy material from enlarged metabolically active developing timely diagnosis appropriate these rare complications. Follow-up without safe detectable microorganisms PCR.