Sarcoidosis, Malignancy, and Immunosuppressive Therapy

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Abstract
Impairment of type IV cell-mediated hypersensitivity reactions have long been recognized as a characteristic of sarcoidosis, and decreased immunological surveillance would be expected to result in an increased occurrence of neoplasia. Evidence that this occurs has been difficult to accumulate, because sarcoidosis develops at an early age in most cases, and because prolonged observation of large numbers of patients with sarcoidosis is difficult. In Denmark, most cases of sarcoidosis and nearly all malignant tumors are reported to national registries. Brincker and Wilbek1 checked the files of both registries and found that, among 2,544 cases of sarcoidosis, with a mean age of 32 years, 48 patients had malignancy simultaneously with or after diagnosis of the sarcoidosis; substantially fewer, 33.8, would have been expected in the Danish general population of similar age and sex. The difference was accounted for entirely by increased numbers of lung cancer and malignant lymphoma, with no

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