Japanese Journal of Clinical Oncology, Vol 27, Issue 2 84-90, Copyright © 1997 by Foundation for Promotion of Cancer Research
M Kojima, S Nakamura, N Futamura, Y Kurabayashi, S Ban, H Itoh, K Yoshida, T Joshita and T Suchi
We conducted clinicopathologic and immunohistochemical analysis of five
patients with malignant lymphoma complicating rheumatic diseases other than
Sjogren's syndrome, and reviewed 26 cases of similar lesions reported in
the Japanese literature over a 17-year period. All five patients were women
ranging in age from 31 to 74 years (mean 55 years). Two of them fulfilled
the diagnostic criteria for systemic lupus erythematosus, two for
dermatomyositis and one for progressive systemic sclerosis. The use of
immunosuppressive drugs before the onset of malignant lymphoma was recorded
in four patients. All the biopsied or resected specimens showed
non-Hodgkin's lymphoma of B-cell phenotype. Three were nodal in origin (one
diffuse mixed, one diffuse large cell and one immunoblastic) and two were
extranodal (one low-grade B-cell lymphoma of mucosa-associated lymphoid
tissue and one diffuse large cell). In three of four cases examined,
Epstein-Barr virus-encoded small RNAs were identified in a small to large
number of the lymphoma cells by in situ hybridization. Our study showed
that the clinicopathological features of malignant lymphomas complicating
rheumatic disease in Japan were similar to those in England and the USA.
Furthermore, our findings suggested no evidence for a causative association
between iatrogenic immunosuppression due to methotrexate therapy and the
development of EBV-related lymphoid neoplasms.
ORIGINAL ARTICLE
Malignant lymphoma in patients with rheumatic diseases other than Sjogren's syndrome: a clinicopathologic study of five cases and a review of the Japanese literature
Department of Pathology, Ashikaga Red Cross Hospital, Japan.
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