Brincker reported the coincidental association between a sarcoid-like reaction and a lymphoproliferative disorder, using the term sarcoidosis-lymphoma syndrome. Whether sarcoidosis predisposes to a lymphoproliferative disorder or is a reaction to it is a matter of controversy.


Lymphoproliferative disorders which may show a sarcoid-like reaction:

(1) non-Hodgkin's disease

(2) Hodgkin's lymphoma

(3) multiple myeloma


A patient with sarcoidosis, lymphoma or both may present with:

(1) FUO

(2) bilateral hilar lymphadenopathy

(3) hepatomegaly


The sarcoid-like reaction may be so extensive as to obscure the lymphoproliferative disorder. Any biopsy showing sarcoidosis should be carefully examined for foci of plasma cells, eosinophils or atypical lymphoid cells; these may be very small and easily overlooked. Molecular techniques may be necessary to demonstrate a monoclonal proliferation.


The presence of an elevated serum angiotensin converting enzyme activity and/or serum calcium can be seen in both sarcoidosis and in non-Hodgkin's and Hodgkin's lymphoma without evidence of sarcoidosis (Dunphy et al, 2000).


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