A 74-year-old woman with interstitial pneumonia, secondary to rheumatoid arthritis, was admitted to hospital because of mediastinal lymphadenopathy. Biopsy of gastric mucosa as well as of cervical lymph node revealed noncaseating epithelioid-cell granuloma. Other laboratory data were also suggestive of sarcoidosis. However, persistent fever and remarkably elevated serum-soluble interleukin-2 receptor levels were also observed. Close examination of the hematoxylin-eosin staining of the cervical lymph nodes revealed atypical multinucleated cells. Finally, immunohistochemical staining of the cervical lymph node specimen showed positive results for CD15, CD30, and Epstein-Barr virus-encoded RNA 1, consistent with Hodgkin lymphoma. We concluded that the noncaseating epithelioid-cell granuloma in both gastric mucosa and cervical lymph nodes constituted a sarcoid reaction. Physicians should be aware that noncaseating epithelioid-cell granuloma in multiple organs is sometimes a sarcoid reaction.