**1. Introduction**

Granulomatous inflammation is a type of chronic tissue reaction characterized histologically by accumulation of epithelioid cells and multinucleated giant cells. Sarcoidosis is a systemic granulomatous disorder of unknown etiology that affects various organs. Sarcoid-like (SL) granulomas/reactions can be seen in patients with malignant tumors without the history of systemic sarcoidosis. These reactions were first described by Wolbach in 1911 [1]. Subsequently, Herxheimer in 1917 reported sarcoidal granulomas in patients with carcinomas of breast, rectum, and cystic duct [2]. These granulomas can occur either within the primary tumor, adjacent to the primary malignancy, in local draining lymph nodes, or in organs distant from the primary malignancy such as the spleen, bone marrow, and skin. This SL reaction is thought to occur in response to antigens expressed by the neoplastic cell or soluble tumor antigens that trigger a T-cell-mediated local immune response. Other etiologies of granuloma formation in patients with malignancy are co-existing sarcoidosis, infectious etiology, and reaction to therapeutic drug or procedure. The SL granulomas have been reported to occur with an average frequency of 14% in Hodgkin lymphoma cases, 7% in non-Hodgkin lymphomas, 50% in seminomas, less than 1% in sarcomas, and 4% in various carcinomas [3, 4].
