Articular, B-cell, non-Hodgkin?s lymphoma mimicking rheumatoid arthritis: synovial involvement in a small hand joint

Abstract

Polyarticular joint manifestations as the predominant symptom of non-Hodgkin's lymphoma (NHL) are quite rare. In the absence of peripheral lymph node and visceral involvement, lymphomas presenting as polyarthritis create a problem for the patients as another rheumatic disease. We present a case that had been diagnosed with rheumatoid arthritis because of symmetrical articular symptoms. The patient later developed severe pain and marked swelling in her right fourth finger, and a diagnosis of septic arthritis and osteomyelitis complicating rheumatoid arthritis was assumed. The final diagnosis of NHL with synovial involvement could be made only after histopathologic examination of a biopsy specimen obtained from the amputated finger. This is the first case report demonstrating direct synovial involvement of a small joint in a patient with NHL presenting with polyarthritis. Articular and periarticular involvement of multiple joints shown by MRI in this patient suggests that direct synovial involvement may be responsible for the polyarticular symptoms in such patients.

Primary pulmonary Hodgkin's lymphoma mimicking rheumatoid arthritis‐associated organizing pneumonia: A case report

“…Autoimmune paraneoplastic disorders have been described in lymphoma 6 . We speculate that polyarthralgia may result from host response to tumor antigens and cytokine‐driven synovial inflammation 7 . Reed–Sternberg cells could secrete a variety of inflammatory cytokines and chemokines, of which interleukin (IL)‐1, IL‐6, and tumor necrosis factor α (TNF‐α) are particularly associated with arthritis, explaining the initial clinical manifestation mimicked rheumatic disease 6 …”

Primary Synovial Diffuse Large B-Cell Lymphoma Presenting as Loosening of Prosthetic Joint: A Case Report and Review of Literature

“…Primary synovium lymphoma without bone involvement is extremely rare. On the review of the English-language literature from 1980 to present, we found 14 cases of primary synovial B-cell NHL [1, 6-18] (Table 1). The reported literature showed various joint involvement such as knee (most common), elbow and small joints of hand and feet.…”

Non-Hodgkin's Lymphoma of the Knee: A Case Report

“…The knee joint (11 cases) is the most commonly involved joint followed by the elbow (two cases), sternoclavicular joint (one case), shoulder (one case) and wrist (one case) ( 1 ). Joint involvement in NHL usually presents with symptoms suggestive of an inflammatory arthropathy or low grade infection such as joint pain, swelling and limitation of movement affecting a single joint rather than multiple joints ( 2 , 5 , 6 ). A minority of patients also has systemic symptoms such as weight loss, night sweats and fever ( 2 , 7 ).…”