Sarcoidosis-lymphoma syndrome: a diagnostic dilemma

BMJ Case Rep. 2017 Dec 14:2017:bcr2017220065. doi: 10.1136/bcr-2017-220065.

Abstract

Sarcoidosis and lymphoma are generally thought of as being two mutually exclusive diseases that need to be considered in the differential diagnosis of patients with hilar/mediastianal lymphadenopathy. However, there are rare patients in whom both of these diseases coexist. These patients constitute a diagnostic challenge because their presentation (ie, clinical symptoms, imaging abnormalities and even pathology) may all be atypical when each individual disease is considered separately. In this report, we describe a patient who presented with such atypical features and was eventually diagnosed as having both sarcoidosis and a B-cell lymphoma with features of splenic marginal zone lymphoma (SMZL) simultaneously. To our knowledge, this is only the second reported case of SMZL and sarcoidosis in the same patient.

Keywords: cancer; cancer intervention; immunology; pathology; respiratory system.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antimetabolites, Antineoplastic / administration & dosage
  • Antimetabolites, Antineoplastic / therapeutic use
  • Cough / etiology
  • Diagnosis, Differential
  • Female
  • Fever / etiology
  • Humans
  • Lymphoma / complications
  • Lymphoma / diagnosis*
  • Lymphoma / diagnostic imaging
  • Methotrexate / administration & dosage
  • Methotrexate / therapeutic use
  • Sarcoidosis / complications
  • Sarcoidosis / diagnosis*
  • Sarcoidosis / diagnostic imaging
  • Splenectomy
  • Splenic Neoplasms / complications
  • Splenic Neoplasms / diagnosis*
  • Splenic Neoplasms / diagnostic imaging
  • Splenic Neoplasms / therapy
  • Tomography, X-Ray Computed

Substances

  • Antimetabolites, Antineoplastic
  • Methotrexate