Lung cancer and chronic interstitial pneumonia associated with systemic sarcoidosis

Lung cancer and chronic interstitial pneumonia associated with systemic sarcoidosis was detected in a 66-year-old woman at autopsy. Histologically, hyalinized sarcoid lesions were scattered in cervical lymph nodes, thoracic lymph nodes, abdominal lymph nodes, and spleen. Scattered non-caseating epithelioid cell granulomas with giant cells were observed in both lungs demoting cancer and chronic interstitial pneumonia. A tumor mass occupying right hilar portion was well-differentiated squamous cell carcinoma involving right upper lobe and right hilar lymph nodes. In the lower lobe of the left lung, a small nodule of poorly differentiated squamous cell carcinoma was detected. Alveolar septa, especially in both lower lobes of the lungs were thickened diffusely with fibrosis, edema, and inflammatory cell infiltration. Alveolar cavities contained hyaline membrane and large mononuclear cells. Atypical bronchiolar epithelial proliferation and squamous metaplasia associated with squamous cell carcinoma were detected. The clinical and pathological characteristics among eight reported cases of lung cancer associated with sarcoidosis and three reported cases of interstitial pneumonia associated with sarcoidosis were reviewed separately. There is no report describing both lung cancer and chronic interstitial pneumonia associated with sarcoidosis.