Noncaseating epithelioid granulomas without accompanying systemic symptoms of sarcoidosis have been described in association with many primary tumors where they are designated as sarcoid-like (SL) reaction. Morphologically, this SL reaction is similar to granulomas found in systemic sarcoidosis comprising of focal accumulation of epithelioid cells and multinucleated giant cells. They can be seen either adjacent to the primary malignancy or in local draining lymph nodes. Additionally, sarcoid-like granulomas can affect other organs distant from the primary neoplasm, such as the spleen, bone marrow, and skin. This sarcoid-like reaction is thought to occur as an immunologic T-cell-mediated response to antigens expressed by the neoplastic cells or soluble tumor antigens. Whether the presence of this sarcoid-like reaction has any prognostic significance in the associated neoplasm is unclear.
Part of the book: Sarcoidosis and Granulomatosis