Occasionally, granulomatous tissue in a sarcoid-like reaction is found surrounding many types of solid-organ tumors. The current medical literature suggests NSCLC existing with true pulmonary sarcoidosis is a rare occurrence. While investigating a possible link between sarcoidosis and malignancy, researchers in Japan and Europe (Brincker and Wilbeck, Askling et al, and Yamaguchi et al) found an increased risk of malignancy in patients with sarcoidosis. In retrospective cohort studies, Brincker and Wilbeck found that 48 patients with sarcoidosis had a malignancy, compared to the 33.8 expected cases in the general population. Of the malignancies detected, lymphoma occurred 11 times more frequently and lung cancer occurred 3 times more frequently than expected. The authors proposed that sarcoidosis increases the risk of malignancy due to a chronic inflammatory state that may cause a malignant transformation of the lymphoid tissue. Other researchers (Romer et al) failed to demonstrate a higher risk for malignancy in patients with sarcoidosis. Because the authors of these studies excluded patients with preexistent cancer, they could not determine if malignancy can engender a systemic granulomatous response similar to sarcoidosis. As of yet, there is no conclusive correlation between sarcoidosis and the promotion of lung cancer.