Non-Hodgkin's lymphoma presenting as polyarthritis / 대한내과학회지

ABSTRACT

Rheumatic manifestations in non-Hodgkin's lymphoma (NHL) are common but actual arthritis as a presenting feature appears to be very rare. We experienced a case of NHL presenting as polyarthritis in a 24-year-old woman. Eight months ago she was admitted to the hospital due to polyarthritis and skin rash. She had pleural and pericardial effusion. Antinuclear antibody was positive and rheumatoid factor was negative. Joint X-ray showed periarticular osteopenia at both knees, wrists, hands and feet. Prednisolone, salsalate and anti-tuberculosis drugs were administered under the impression of either probable lupus or rheumatoid arthritis and pleural tuberculosis. After then pleuropericardial effusion and skin rash improved. But polyarthralgia persisted and she developed right cervical lymphadenopathy. On her second admission she was found to have a round mass in left lower lung field and multiple mediastinal lymph node enlargement. Cervical lymph node biopsy revealed non-Hodgkin's lymphoma. She received 8 cycles of systemic chemotherapy until 1996 July. NHL was remitted completely and polyarthralgia disappeared. We report a case of non-Hodgkin's lymphoma presenting as polyarthritis and literatures are reviewed.