Sarcoidosis occurring after lymphoma: report of 14 patients and review of the literature.
Sarcoidosis is a granulomatous disease that most frequently affects the lungs with pulmonary infiltrates and/or bilateral hilar and mediastinal lymphadenopathy. An association of sarcoidosis and lymphoproliferative disease has previously been reported as the sarcoidosis-lymphoma syndrome. Although this syndrome is characterized by sarcoidosis preceding lymphoma, very few cases of sarcoidosis following lymphoma have been reported. We describe the clinical, biological, and radiological characteristics and outcome of 39 patients presenting with sarcoidosis following lymphoproliferative disease, including 14 previously unreported cases and 25 additional patients, after performing a literature review. Hodgkin lymphoma and non-Hodgkin lymphoma were equally represented. The median delay between lymphoma and sarcoidosis was 18 months. Only 16 patients (41%) required treatment. Sarcoidosis was of mild intensity or self-healing in most cases, and overall clinical response to sarcoidosis was excellent with complete clinical response in 91% of patients. Sarcoidosis was identified after a follow-up computerized tomography scan (CT-scan) or fluorodeoxyglucose-positron emission tomography/computerized tomography (FDG-PET/CT) evaluation in 18/34 patients (53%). Sarcoidosis is therefore a differential diagnosis to consider when lymphoma relapse is suspected on a CT-scan or FDG-PET/CT, emphasizing the necessity to rely on histological confirmation of lymphoma relapse.
Department of Internal Medicine (JL, CLL, LG, NC-C, LM, BT), National Referral Center for Rare Systemic and Autoimmune Diseases; Department of Hematology (BD), Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Descartes; Department of Hematology (EC); Department of Internal Medicine (CC-A), Pitié-Salpêtrière Hospital, AP-HP; Department of Onco-Hematology (PB), Saint-Louis Hospital, AP-HP; Department of Pathology (BB), Hôtel-Dieu Hospital, AP-HP; Department of Thoracic Surgery (MA), Cochin Hospital, AP-HP, Paris; Department of Internal Medicine (AC, FM), Belle Isle Hospital, Metz; Department of Internal Medicine (AG, NS), CHU Conception, Assistance Publique-Hôpitaux de Marseille, Marseille; Department of Medicine (CF), Gustave Roussy, Villejuif; and Lymphoid Malignancies Unit (CH), Henri Mondor Hospital, AP-HP, Créteil, France.
Jonathan
J
London
Aurélie
A
Grados
Christophe
C
Fermé
Alexandre
A
Charmillon
François
F
Maurier
Bénédicte
B
Deau
Etienne
E
Crickx
Pauline
P
Brice
Catherine
C
Chapelon-Abric
Corinne
C
Haioun
Barbara
B
Burroni
Marco
M
Alifano
Claire
C
Le Jeunne
Loïc
L
Guillevin
Nathalie
N
Costedoat-Chalumeau
Nicolas
N
Schleinitz
Luc
L
Mouthon
Benjamin
B
Terrier
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D001856:Bone Marrow Examination; D005260:Female; D005602:France; D006801:Humans; D008168:Lung / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008223:Lymphoma / Q000150:complications / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy / Q000379:methods*; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D000069283:Rituximab; D012469:Salivary Glands / Q000473:pathology; D012507:Sarcoidosis / Q000209:etiology / Q000473:pathology / Q000628:therapy; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab