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"documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2023;160:277" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Sarcoidosis and lymphoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "277" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sarcoidosis y linfoma" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jose Luis Callejas Rubio, Noberto Ortego Centeno" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Jose Luis" "apellidos" => "Callejas Rubio" ] 1 => array:2 [ "nombre" => "Noberto" "apellidos" => "Ortego Centeno" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775322005401" "doi" => "10.1016/j.medcli.2022.09.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775322005401?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623000803?idApp=UINPBA00004N" "url" => "/23870206/0000016000000006/v1_202303262137/S2387020623000803/v1_202303262137/en/main.assets" ] "asociados" => array:1 [ 0 => array:19 [ "pii" => "S2387020623000803" "issn" => "23870206" "doi" => "10.1016/j.medcle.2022.09.022" "estado" => "S300" "fechaPublicacion" => "2023-03-24" "aid" => "6105" "copyright" => "Elsevier España, S.L.U." 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Roberto Pérez-Álvarez, Manuel Ramos-Casals" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Pilar" "apellidos" => "Brito-Zerón" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "Roberto" "apellidos" => "Pérez-Álvarez" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:4 [ "nombre" => "Manuel" "apellidos" => "Ramos-Casals" "email" => array:1 [ 0 => "mramos@clinic.cat" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Research and Innovation Group in Autoimmune Diseases, Sanitas Digital Hospital, Hospital-CIMA-Centre Mèdic Millenium Balmes Sanitas, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Línea de investigación de Sarcoidosis del Grupo de Enfermedades Autoinmunes Sistémicas (GEAS), Sociedad Española de Medicina Interna (SEMI), Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital San Rafael, La Coruña, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Enfermedades Autoinmunes, Instituto Clínic de Medicina y Dermatología (ICMiD), Hospital Clínic, Barcelona, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Departament de Medicina, Universitat de Barcelona, Barcelona, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We appreciate the comments made by Drs Callejas and Ortego, which allow us to delve into an important clinical aspect of the disease.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We have preferred to avoid the expression recommended by the authors ("sarcoidosis-lymphoma syndrome"), since we believe that using the term "syndrome" to describe the association between 2 different diseases is etymologically incorrect and, therefore, we advise against its use. Instead, we have found it more appropriate to highlight in the text that the association of sarcoidosis and cancer is frequent, it occurs in both solid and hematologic malignancies, and that the diagnosis of cancer can be prior to, concomitant with, or subsequent to the diagnosis of sarcoidosis,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> including as a citation the same reference included by Drs Callejas and Ortego as number 3 in their letter to the editor.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Regarding the differential (or prognostic) value of the PET scan’s intensity of metabolic uptake of sarcoid lymph nodes, most studies show that PET is incapable of distinguishing sarcoidosis-related lymph nodes from malignancy-related lymph nodes.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–5</span></a> Therefore, this scan provides very limited information to differentiate both diseases and a histopathological study would be required to confirm the diagnosis.</p><p id="par0020" class="elsevierStylePara elsevierViewall">From a practical point of view, in everyday healthcare the main scenarios to consider in the complex relationship between sarcoidosis and lymphoma are:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1</span><p id="par0025" class="elsevierStylePara elsevierViewall">The casual finding of sarcoidosis in the biopsy of bilateral mediastinal adenopathies whose main suspicion is intrathoracic lymphoma (sarcoidosis that mimics lymphoma as a clinical presentation).</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2</span><p id="par0030" class="elsevierStylePara elsevierViewall">The existence of granulomas which coexist in the same histopathological sample that shows cancerous tumor infiltration, known as a sarcoid-like reaction, and that has been seen in both hematological (Hodgkin and Burkitt lymphoma) and solid (kidney and ovarian) malignancies (a exclusively histopathological finding and that is not related to sarcoidosis as a disease).</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3</span><p id="par0035" class="elsevierStylePara elsevierViewall">The increased risk of developing hematologic malignancies in the patient with sarcoidosis, as occurs with the patient with Sjögren's syndrome (the autoimmune disease predisposes to the development of a neoplastic complication). This scenario is little studied to date and its characterisation we are currently finalising, using the SarcoGEAS National Registry of the SEMI to identify possible prognostic factors.</p></li></ul></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical considerations</span><p id="par0040" class="elsevierStylePara elsevierViewall">Not applicable.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Financing</span><p id="par0045" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interests</span><p id="par0050" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Ethical considerations" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Financing" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflict of interests" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. 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