Paraneoplastic Sarcoidosis in Multiple Myeloma

Kusaba, Koji; Kojima, Kensuke; Naito, Shinji; Taba, Mitsuru; Kai, Keita; Ureshino, Hiroshi; Nishida, Yuichiro; Kimura, Shinya

doi:10.2169/internalmedicine.56.8331

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…In our review of the literature, 33 cases with both sarcoidosis and MM were identified although patient characteristics and diagnostic information were not available for all of them [4, 6–25]. Data analyses showed female gender predominance, with a median age at sarcoidosis diagnosis of 46 years (24–65).…”

Section: Discussionmentioning

confidence: 99%

Sarcoidosis and Multiple Myeloma: A Case Report and Literature Review

Serra

Martinho

Duarte

et al. 2019

Case Reports in Hematology

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The existence of a sarcoidosis-lymphoma syndrome has been previously proposed since the relation between sarcoidosis and an increased risk of lymphoproliferative disorders is well established. Multiple myeloma is a malignant multifocal proliferation of clonal plasma cells within the bone marrow, and its association with sarcoidosis has been rarely described. We present a concurrent diagnosis of sarcoidosis and multiple myeloma and make a brief analysis of the reported cases in the literature. A 65-year-old woman underwent surgery for the excision of a wrist mass that presented 3 years before. Histological analysis showed sarcoid-type epithelioid granulomas without necrosis, establishing soft tissue sarcoidosis. Further evaluation revealed marked interstitial lung parenchyma lesions and large intrathoracic adenopathies. Bronchofibroscopy with transbronchial biopsy confirmed lung sarcoidosis. In addition, blood analysis showed monoclonal IgG kappa gammopathy. A bone marrow biopsy confirmed hypercellularity with 60% plasma cells and plasmocyte infiltration. Thus, the diagnosis of systemic sarcoidosis and multiple myeloma was established simultaneously. In a brief review of the literature, we identified 33 reports of cases with both sarcoidosis and multiple myeloma. We point out the importance of a high level of suspicion for the association of sarcoidosis with malignant haematological diseases such as multiple myeloma.

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Section: Discussionmentioning

confidence: 99%

Sarcoidosis and Multiple Myeloma: A Case Report and Literature Review

Serra

Martinho

Duarte

et al. 2019

Case Reports in Hematology

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“…The association between sarcoidosis and lymphoma is well established and the sarcoidosis-lymphoma syndrome was first described in 1986 by Brincker and Wilbek 8. However, there are very few reports of an association between sarcoidosis and multiple myeloma 9–12. Herein, we report a case of paraneoplastic sarcoidosis occurring in a patient progressing from smouldering to symptomatic multiple myeloma.…”

Section: Introductionmentioning

confidence: 82%

Dual pathology: paraneoplastic sarcoidosis emerging at the time of progression from smouldering to symptomatic myeloma

Aquil,

Giles,

Buka

et al. 2023

BMJ Case Rep

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Sarcoidosis is a systemic disease of unknown aetiology, which is diagnosed based on the presence of non-caseating granulomas on histology. The occurrence of sarcoidosis or a sarcoidosis-like reaction with malignancy has been recognised for several years. Although it has been established that there is an increased risk of lymphoproliferative disorder with sarcoidosis, the association between multiple myeloma and sarcoidosis has rarely been reported. Here, we report the case of woman in her mid-50s with an established diagnosis of smouldering myeloma, who presented with gradually worsening shortness of breath and fatigue after 15 months of active observation. A CT scan of her thorax showed mediastinal lymphadenopathy and the nodes were metabolically active on positron emission tomography CT scan. Endobronchial ultrasound with transbronchial needle aspiration confirmed the diagnosis of sarcoidosis. Further evaluation showed preserved lung function on spirometry. Blood analysis showed a simultaneous rise in the serum lambda-free light chain level from 377 mg/L at initial diagnosis up to 807 mg/L with the kappa/lambda ratio falling to 0.012. Repeat bone marrow aspirate and trephine biopsy showed a 15%–20% infiltrate of lambda light chain-restricted plasma cells with aberrant cyclin D1 expression and abundant sarcoid-like non-necrotising giant cell granulomata. Thus, a diagnosis of paraneoplastic sarcoidosis was established.

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“…Additionally, there exists the entity of “sarcoid reactions,” which are localized forms of noncaseating granulomas of adjacent lymph nodes. There appears to be a reaction to antigens draining from the malignancy rather than an actual systemic form of sarcoidosis 5, 6…”

Section: Discussionmentioning

confidence: 99%