Is sarcoidosis frequent in patients with cancer?

Abstract

To examine the recent advancements of the epidemiology, pathophysiology, and clinical characteristics in patients who have a history of sarcoidosis and cancer. A longitudinal study examined 1153 patients with sarcoidosis utilizing the computerized healthcare dataset available in the United Kingdom. The authors found increased incidence of cancer in patients with sarcoidosis mainly due to skin cancer (rate ratio 1.86; 95% confidence interval 1.11-3.11). Endobronchial ultrasound guided transbronchial needle aspiration for mediastinal adenopathy in patients found 11% (17 out of 153) of patients to have noncaseating granulomas. Of the 17 patients, eight had sarcoid-like lymphadenopathy, another eight had sarcoidosis, and one had nontuberculous mycobacterial infection. Another study examined the presence of granulomas in patients with testicular carcinoma, which showed either sarcoid-like reaction or sarcoidosis. Eighty percent of patients with granulomas regressed spontaneously and did not appear to affect the prognosis of cancer. Is there a causal or accidental relationship between sarcoidosis and cancer? We do not know. However, we would like to propose the term 'sarcoid-cancer syndrome' that would encompass sarcoid-like reaction and multisystem sarcoidosis occurring in patients with cancer and various lymphomas. Further studies are needed to elucidate the precise mechanism and epidemiology, clinical features, and pathogenesis of this phenomenon.