Granulomatous/sarcoid-like reactions in the setting of programmed cell death-1 inhibition: a potential mimic of disease recurrence.

Abstract

Nivolumab and pembrolizumab are humanized IgG4 monoclonal antibodies against programmed cell death 1 (PD-1). Although these agents are effective in treating advanced melanoma, non-small-cell lung carcinoma, and other types of cancers, various adverse events have been reported. Cutaneous adverse events are particularly prevalent and, while granulomatous/sarcoid-like reactions are uncommon, they are increasingly recognized as immune-related adverse events associated with immune checkpoint inhibitors. Herein, we report two cases of granulomatous/sarcoid-like reaction with foreign material, mimicking metastatic malignancy after PD-1 inhibitor treatment. Clinicians should be aware of the existence of cutaneous lesions and perform biopsy if needed to prevent misdiagnosis and unnecessary adjustments to immunotherapy.

• Authors: Tsubasa Hiraki, Miho Hatanaka, Akiko Arimura, Hisao Kawahira, Mari Kirishima, Ikumi Kitazono, Michiko Horinouchi, Michiyo Higashi, Takuro Kanekura, Akihide Tanimoto
• Journal: Journal of cutaneous pathology (J Cutan Pathol) Vol. 47 Issue 2 Pg. 154-160 (Feb 2020) ISSN: 1600-0560 [Electronic] United States
• PMID: 31437317 (Publication Type: Case Reports)
• Copyright: © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Neoplasm Proteins
• PDCD1 protein, human
• Programmed Cell Death 1 Receptor
• Nivolumab

Topics

• Aged
• Drug Eruptions (diagnosis, metabolism, pathology)
• Humans
• Male
• Melanoma (diagnosis, drug therapy, metabolism, pathology)
• Neoplasm Metastasis
• Neoplasm Proteins (antagonists & inhibitors, metabolism)
• Nivolumab (administration & dosage, adverse effects)
• Programmed Cell Death 1 Receptor (antagonists & inhibitors, metabolism)
• Rectal Neoplasms (diagnosis, drug therapy, metabolism, pathology)