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Letter to the Editor
Reply
Respuesta
Pilar Brito-Zeróna,b, Roberto Pérez-Álvarezb,c, Manuel Ramos-Casalsb,d,e,
Corresponding author
mramos@clinic.cat

Corresponding author.
a Research and Innovation Group in Autoimmune Diseases, Sanitas Digital Hospital, Hospital-CIMA-Centre Mèdic Millenium Balmes Sanitas, Barcelona, Spain
b Línea de investigación de Sarcoidosis del Grupo de Enfermedades Autoinmunes Sistémicas (GEAS), Sociedad Española de Medicina Interna (SEMI), Madrid, Spain
c Servicio de Medicina Interna, Hospital San Rafael, La Coruña, Spain
d Servicio de Enfermedades Autoinmunes, Instituto Clínic de Medicina y Dermatología (ICMiD), Hospital Clínic, Barcelona, Spain
e Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We appreciate the comments made by Drs Callejas and Ortego&#44; which allow us to delve into an important clinical aspect of the disease&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We have preferred to avoid the expression recommended by the authors &#40;&#34;sarcoidosis-lymphoma syndrome&#34;&#41;&#44; since we believe that using the term &#34;syndrome&#34; to describe the association between 2 different diseases is etymologically incorrect and&#44; therefore&#44; we advise against its use&#46; Instead&#44; we have found it more appropriate to highlight in the text that the association of sarcoidosis and cancer is frequent&#44; it occurs in both solid and hematologic malignancies&#44; and that the diagnosis of cancer can be prior to&#44; concomitant with&#44; or subsequent to the diagnosis of sarcoidosis&#44;<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&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Regarding the differential &#40;or prognostic&#41; value of the PET scan&#8217;s intensity of metabolic uptake of sarcoid lymph nodes&#44; most studies show that PET is incapable of distinguishing sarcoidosis-related lymph nodes from malignancy-related lymph nodes&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;5</span></a> Therefore&#44; this scan provides very limited information to differentiate both diseases and a histopathological study would be required to confirm the diagnosis&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">From a practical point of view&#44; in everyday healthcare the main scenarios to consider in the complex relationship between sarcoidosis and lymphoma are&#58;<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 &#40;sarcoidosis that mimics lymphoma as a clinical presentation&#41;&#46;</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&#44; known as a sarcoid-like reaction&#44; and that has been seen in both hematological &#40;Hodgkin and Burkitt lymphoma&#41; and solid &#40;kidney and ovarian&#41; malignancies &#40;a exclusively histopathological finding and that is not related to sarcoidosis as a disease&#41;&#46;</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&#44; as occurs with the patient with Sj&#246;gren&#39;s syndrome &#40;the autoimmune disease predisposes to the development of a neoplastic complication&#41;&#46; This scenario is little studied to date and its characterisation we are currently finalising&#44; using the SarcoGEAS National Registry of the SEMI to identify possible prognostic factors&#46;</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&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Financing</span><p id="par0045" class="elsevierStylePara elsevierViewall">None&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interests</span><p id="par0050" class="elsevierStylePara elsevierViewall">None&#46;</p></span></span>"
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