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Pathogenetic Mechanisms Linking Sarcoidosis to Lymphoma
Styliani Voutidou1, Dimitrios Eleftheriadis1, Fotios Drakopanagiotakis1
1Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, 68100 Alexandroupolis, Greece.
Abstract:
Sarcoidosis and lymphoma share immunopathological characteristics that suggest a complex, interconnected relationship. This article examines the multi-faceted mechanisms linking sarcoidosis to lymphoma, a phenomenon called sarcoidosis-lymphoma syndrome (SLS). SLS is hard to diagnose, requiring distinct criteria and imaging to differentiate overlapping features and histological differences. The co-occurrence of these diseases may be explained by genetic predispositions, immune dysregulation, and environmental factors that enhance malignancy risk. In active sarcoidosis, chronic inflammation and granuloma formation induce the production of cytokines that can contribute to lymphoma development. The role of macrophage polarization is also discussed. Immunosuppressive treatment prescribed in sarcoidosis patients, particularly corticosteroids and biological agents, may increase the susceptibility to lymphoproliferative malignancies. These common mechanisms emphasize the need for vigilant monitoring of lymphoma in patients with sarcoidosis, as this granulomatous disease can mimic and promote the development of lymphoma.
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