CTICasesSarcoid-Lymphoma Syndrome (Diffuse Large B-Cell Lymphoma)
Imaging findings
A patient with bilateral intraocular lesions, evaluated for granulomatous disease or malignancy, has upper lobe fuzzy ground-glass nodules, many along the fissures in a perilymphatic distribution, with subpleural involvement, plus a small pericardial effusion. There are a few discrete liver lesions that do not look sarcoid-like. Liver biopsy returned diffuse large B-cell lymphoma.
Key takeaways
Perilymphatic ground-glass nodules can suggest sarcoidosis (a recognized cause of ground-glass nodularity), but discrete non-sarcoid-appearing extrapulmonary lesions warrant biopsy, which here revealed diffuse large B-cell lymphoma. The combination raises the sarcoid-lymphoma syndrome, in which a sarcoid-like reaction accompanies lymphoma, and the intraocular disease was ultimately attributed to the lymphoma as well.
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