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Wednesday, March 4, 2015
Sarcoidosis with lymphoma
I have been diagnosed with Sarcoid through CT, PET and mediastinoscopy. The PET showed SUV`s exceeding 10.5 in my spleen, and up to 10 in numerous other organs. I have had absolutely no symptoms of sarcoid at all, and have read about concurrent existence of lymphoma with sarcoid. How likely is it that the bx was of sarcoid, but that the numerous extremely hot spots on PET are lymphoma? I am already a breast cancer survivor (7 years) and my mother died of metastic cancer, unknown primary within 3 months of diagnosis, this past year. Should I consult an oncologist, or am I just overconcerned given my history and the PET report which indicated dx of mets or lymphoma?
Thank you for your time.
I understand your concern, and this is a common problem. Enlarged lymph nodes or manifestations in the spleen and other organs (e.g., as reflected by positive PET scan) is a common feature of sarcoidosis, but can be seen with cancer (e.g., lymphoma) as well. The fact that you had a lymph node biopsy in the chest is strong evidence to support the diagnosis of sarcoidosis. Rarely, sarcoidosis can occur in the vicinity of a cancer or can occur in a patient who simultaneously has lymphoma.
Given your history of cancer, it is reasonable to seek consultation from an oncologist. At the very least, these metabolically active areas should be followed to see if they change over time.
Elliott D Crouser, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University