Inflammatory myopathies and lymphoma

Follicular lymphoma associated paraneoplastic myositis

“…DM/PM associated with cancer usually predates the diagnosis of the malignancy; however, in the 15%-30% of patients in which hematological malignancy preceded the diagnosis of DM/PM, the inflammatory myopathy was typically diagnosed within the first two years following diagnosis, with <1.6% of cases occurring after 5 years. 4,5,8 The patient presented here was diagnosed with stage IV follicular lymphoma twelve years before presenting with symptoms consistent with myositis. The sequence and significant lapse of time between diagnosis of lymphoma and onset of myopathy suggests an alternative underlying pathology than that of a cancer associated DM or PM.…”

“…Cancer associated inflammatory myopathies are rare syndromes occurring in 10%-30% of all malignancies, with paraneoplastic myopathies accounting for only 15% of this unusual condition. 4,7 Inflammatory myopathies associated with hematological malignancies are even rarer entities, first defined in a retrospective analysis and literature review by Marie, et al in 2011. Lymphoma is the most common hematological malignancy associated with inflammatory myopathies, with B-cell lymphomas comprising 54%-62% of all cases.…”

“…[2][3][4] They preferentially involve proximal musculature, and in the case of DM, pathognomonic cutaneous manifestations are seen. [2][3][4]5 The disease course of cancer associated inflammatory myopathies usually parallels that of the malignancy, achieving remission or progressing simultaneously. 2,4,6 Therefore, treatment of these inflammatory myopathies usually consists of cytotoxic therapy targeted exclusively at the malignancy.…”

“…[2][3][4]5 The disease course of cancer associated inflammatory myopathies usually parallels that of the malignancy, achieving remission or progressing simultaneously. 2,4,6 Therefore, treatment of these inflammatory myopathies usually consists of cytotoxic therapy targeted exclusively at the malignancy. 2,4 We identified two case reports of FL and DM diagnosed concurrently in the literature that were successfully treated with lymphoma-directed chemotherapy.…”

“…2,4,6 Therefore, treatment of these inflammatory myopathies usually consists of cytotoxic therapy targeted exclusively at the malignancy. 2,4 We identified two case reports of FL and DM diagnosed concurrently in the literature that were successfully treated with lymphoma-directed chemotherapy. 2,3 Here, we present a patient with relapsed/refractory stage IV follicular lymphoma with paraneoplastic myopathy, who was unable to tolerate additional cycles of chemotherapy and was accordingly managed with high-dose corticosteroids with rapid clinical improvement.…”