类风湿关节炎中的淋巴瘤——一种常见疾病的灾难性后果

Lymphoma in Rheumatoid Arthritis - Catastrophic Sequela of a Common Disease.

作者信息

Nagpal Swapan Deep Singh, Singh Narinder Pal, Mishra Pravas, Singh Angad

机构信息

Resident, Max Super Speciality Hospital, Vaishali, Uttar Pradesh.

Senior Director and Medical Advisor, Department of Internal Medicine, Max Super Speciality Hospital, Vaishali, Uttar Pradesh.

出版信息

J Assoc Physicians India. 2018 Jul;66(7):87-89.

PMID:31325274

Abstract

Rheumatoid arthritis (RA) is a common rheumatological condition affecting the joints and has a wide range of extra-articular manifestations. A 69 year old male, known case of rheumatoid arthritis presented to our OPD with right lower limb redness and swelling, and left axillary lymph node swelling. Lymph node biopsy revealed a high grade diffuse large B-cell lymphoma with co-expression of c-myc and bcl-2 (double expressor). RA increases the risk of both Hodgkin's lymphoma (HL) and non-Hodgkin's Lymphoma (NHL). The association with diffuse large B-cell lymphoma (DLBCL) has been found to be particularly strong, however double expressor DLBCL is an extremely uncommon occurrence. High disease activity of rheumatoid arthritis is a major determinant in development of lymphomas.

摘要

类风湿性关节炎（RA）是一种影响关节的常见风湿性疾病，具有广泛的关节外表现。一名69岁男性，已知类风湿性关节炎患者，因右下肢红肿和左腋窝淋巴结肿大前来我院门诊就诊。淋巴结活检显示为高级别弥漫性大B细胞淋巴瘤，伴有c-myc和bcl-2共表达（双表达者）。RA会增加霍奇金淋巴瘤（HL）和非霍奇金淋巴瘤（NHL）的发病风险。已发现其与弥漫性大B细胞淋巴瘤（DLBCL）的关联尤为密切，然而双表达DLBCL极为罕见。类风湿性关节炎的高疾病活动度是淋巴瘤发生的主要决定因素。