Association lymphome et granulomatose : à propos d’une série de cas

Charry, F. de; Sadoune, K.; Sebban, Catherine; Rey, Philippe; Parisot, Audrey de; Nicolas‐Virelizier, Emmanuelle; Belhabri, Amine; Ghesquières, Hervé; Ninet, J.; Faurie, Pierre

doi:10.1016/j.revmed.2015.10.344

Cited by 5 publications

(2 citation statements)

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“…In 43% of patients, the diagnosis of sarcoidosis was made more than 5 years after the diagnosis of cancer. De Charry et al described the characteristics of granulomatosis occurring in the context of lymphoma (56). In this study, the patients developed granulomatosis at a median age of 60 while typical sarcoidosis usually occurs before 50 with a peak of incidence between 20 and 39 (1).…”

Section: Sarcoidosis and Sarcoid-like Reactions In The Course Of Cancermentioning

confidence: 59%

Sarcoidosis and Cancer: A Complex Relationship

et al. 2020

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Sarcoidosis is a systemic disease of unknown etiology, characterized by the presence of non-caseating granulomas in various organs, mainly the lungs, and the lymphatic system. Since the individualization of sarcoidosis-lymphoma association by Brincker et al., the relationship between sarcoidosis or granulomatous syndromes and malignancies has been clarified through observational studies worldwide. Two recent meta-analyses showed an increased risk of neoplasia in sarcoidosis. The granulomatosis can also reveal malignancy, either solid or hematological, defining paraneoplastic sarcoidosis. Recent cancer immunotherapies, including immune checkpoint inhibitors (targeting PD-1, PD-L1, or CTLA-4) and BRAF or MEK inhibitors were also reported as possible inducers of sarcoidosis-like reactions. Sarcoidosis and neoplasia, especially lymphoma, can show overlapping presentations, thus making the diagnosis and treatment harder to deal with. There are currently no formal recommendations to guide the differential diagnosis workup between the evolution of lymphoma or a solid cancer and a granulomatous reaction associated with neoplasia. Thus, in atypical presentations (e.g., deeply impaired condition, compressive lymphadenopathy, atypical localization, unexplained worsening lymphadenopathy, or splenomegaly), and treatment-resistant disease, targeted biopsies on suspect localizations with histological examination could help the clinician to differentiate neoplasia from sarcoidosis. Pathological diagnosis could sometimes be challenging since very few tumor cells may be surrounded by massive granulomatous reaction. The sensitization of currently available diagnostic tools should improve the diagnostic accuracy, such as the use of more “cancer-specific” radioactive tracers coupled with Positron Emission Tomography scan.

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Section: Sarcoidosis and Sarcoid-like Reactions In The Course Of Cancermentioning

confidence: 59%

Sarcoidosis and Cancer: A Complex Relationship

et al. 2020

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“…When a granuloma appears during the progression of cancer especially with the use of chemotherapy and/or anti-cancerous immunotherapy or long after the end of a treatment period, many diagnostic hypotheses maybe considered, most notably, tuberculosis, histoplasmosis, a primary or secondary immune deficiency, an inflammatory enteropathy, a generalized annular granuloma, a progressing or a recurrent tumor, a granulomatous reaction to anti-cancerous treatment or an authentic systemic sarcoidosis [22].…”

Section: Discussionmentioning

confidence: 99%

Systemic Granulomatosis in the Context of Solid Tumors: A Study of 10 Cases

Fares

Benzakour

Al-Azhari

et al. 2022

JCTI

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Introduction: The association between solid cancers and sarcoidosis is well-known, however,we shouldn’t quickly link a granulomatous lesion to sarcoidosis in a patient suffering from a solid tumor, hence, a granuloma in the context of a solid cancer presents a diagnostic and a therapeutic challenge. Methods: It’s a retrospective monocentric study of 10 cases, suffering from solid tumors, with granulomatous lesions. The type of cancer, the temporal relation between the granulomatous lesion and the cancer, the associated symptoms, the final diagnosis and the disease progression are reported. The patients were separated into three sub groups based on the time of appearance of the granulomatous lesions in relation to the solid tumor. Results: Discovery of granulomatous lesions preceded the diagnosis of cancer in 1 case, discovered concomitantly with cancer in 5 cases and finally after the cancer in 4 cases. The main solid cancer in our study was breast invasive ductal carcinoma (40%), the other cancers were: squamous cell carcinoma of the breast, colorectal adenocarcinoma, ovarian epithelial cancer, esophageal squamous cell carcinoma, thyroid papillary carcinoma and uterine sarcoma. Conclusion: A granuloma in the course of solid cancers maybe associated with multiple etiologies. Therefore, the clinician may face many difficulties, ranging from failing to diagnose a cancer to a wrong conclusion of treatment failure or a relapse. The biopsy is still the only guiding element.

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