Shen Jeffrey Z, Carlsen Eric D, Carrillo Luis F, Cintron Dahima, Kellogg Ben, Lim Jamie, Nicholas Matilda, Lackey Elijah, Dasher John
Duke Department of Medicine, Division of Rheumatology and Immunology, NC, Durham, USA.
Duke Medicine Cir Clinic 1J, 27710, Durham, NC, USA.
Curr Allergy Asthma Rep. 2025 Sep 16;25(1):38. doi: 10.1007/s11882-025-01220-x.
Lymphoproliferative disorders encompass a variety of hematologic diseases that are increasingly recognized. Patients with these conditions may present to rheumatologists or other specialists prior to a hematologist-oncologist. This review is intended to highlight key distinguishing features between rheumatologic conditions and lymphoproliferative disorders, and suggest diagnostic approaches.
Recent studies have shown that lymphoproliferative diseases can mimic rheumatologic disease, and differentiation is complex. Advances in imaging techniques such as FDG PET/CT, and improved understanding of lymph node histopathology have improved diagnostic accuracy. Attention to specific details such as the pattern of organ involvement, the presence or absence of key clinical features, and the consistency of treatment response can assist in accurate diagnosis. Our review highlights the importance of considering lymphoproliferative disorders in the differential diagnosis of rheumatologic disease. A thorough clinical history, targeted biopsies, and collaboration with hematopathologists are essential for timely diagnosis and care. Future research should concentrate on identifying biomarkers and formulating diagnostic algorithms to aid in differentiating lymphoproliferative disorders from autoimmune diseases, which will ultimately improve patient outcomes.
淋巴增殖性疾病涵盖了越来越多被认识的各种血液系统疾病。患有这些疾病的患者可能在血液肿瘤学家之前就就诊于风湿病学家或其他专科医生。本综述旨在强调风湿性疾病和淋巴增殖性疾病之间的关键区别特征，并提出诊断方法。
最近的研究表明，淋巴增殖性疾病可模仿风湿性疾病，且鉴别复杂。诸如FDG PET/CT等成像技术的进展以及对淋巴结组织病理学认识的提高提高了诊断准确性。关注特定细节，如器官受累模式、关键临床特征的有无以及治疗反应的一致性，有助于准确诊断。我们的综述强调了在风湿性疾病鉴别诊断中考虑淋巴增殖性疾病的重要性。详尽的临床病史、靶向活检以及与血液病理学家的合作对于及时诊断和治疗至关重要。未来的研究应集中于识别生物标志物并制定诊断算法，以帮助区分淋巴增殖性疾病与自身免疫性疾病，这最终将改善患者的治疗结果。
