Pulmonary sarcoid-like granulomata in a patient treated for extrapulmonary Hodgkin's disease

We report a case of interstitial lung disease developing during treatment with chlorambucil, vinblastine, procarbazine and prednisone for extrapulmonary Hodgkin's disease. Transbronchial biopsies demonstrated noncaseating epithelioid cell granulomata, and bronchoalveolar lavage fluid showed an increased percentage of lymphocytes, with a raised T cell helper-suppressor ratio, suggesting a diagnosis of sarcoidosis. Treatment with corticosteroids brought about complete resolution of the radiographic lesions. A possible relationship between sarcoidosis and lymphoma is discussed, and a short review of the literature is given. This case report has some unique features that, to our knowledge, have not been published before.