Abstract
Background. It has been suggested that patients with sarcoidosis are at an increased risk of development of cancer. Case. A 73-year-old man complaining of fever, fatigue and abnormal visual field presented with chest X-ray abnormalities. Chest CT showed bilateral multiple nodular lesions in the lung fields, tumor in the mediastinum and hilar lymphadenopathy. Positron emission tomography/computed tomography showed excessive FDG uptake in the mediastinal tumor, bilateral hilar lymph nodes, and the right testis. Bronchoscopy and transbronchial biopsy confirmed the diagnosis of sarcoidosis, and the patient was started on oral corticosteroid therapy. Since the right testis became bigger, so orchidectomy of the right testis was performed, and histopathology of the resected specimen revealed the diagnosis of malignant lymphoma. The chest CT showed enlargement of the subcarinal lymph node, and EBUS-TBNA of the lymph node revealed metastasis from the malignant lymphoma. Conclusion. Both malignant lymphoma and sarcoidosis can be associated with positive uptake on FDG-PET, making it difficult to differentiate between the two when they occur concurrently. We encountered a case of malignant lymphoma and sarcoidosis occurring concurrently, which made precise timely diagnosis difficult.
