Diffuse large B cell lymphoma masked under a mixed connective tissue disease

Diffuse large B cell lymphoma masked under a mixed connective tissue disease

A.A. Klimenko^1,2, T.K. Loginova¹, G.R. Avetisian¹, M.N. Musayeva¹, L.D. Makalova¹ 

¹Pirogov Russian National Research Medical University, Moscow

²N.I. Pirogov City Clinical Hospital No. 1, Moscow 

Non-Hodgkin lymphoma (NHL) is a heterogeneous group of malignant lymphoproliferative disorders that differ in morphological structure, biological attributes, and clinical picture. The most well-known type of NHL is diffuse large B cell lymphoma (DLBCL), which most nonspecific signs are the result of paraneoplastic disorders variety. The article presents a clinical case of a 61-year-old patient in whom DLBCL manifested under the mask of a mixed connective tissue disease. During 1 year, the patient had a variety of clinical syndromes: intoxication, recurrent arthritis, Raynaud’s syndrome, lung disease. He was admitted to the Rheumatology Department with a directional diagnosis of mixed connective tissue disease of unclear etiology to verify the diagnosis. According to the abdominal CT scan, retroperitoneal lymphadenopathy and splenomegaly were detected. Whereas the examination results allowed to establish a lymphoproliferative disorder, which was later confirmed by the results of an immunohistochemistry — DLBCL The article also notes the difficulties in diagnosing lymphoma due to the disease polymorphism, and highlights some common signs that suggest the presence of a paraneoplastic rheumatic disorder.

Keywords: B symptoms, paraneoplastic disorder, lymphoma, immunohistochemistry, lymphadenopathy.

For citation: Klimenko A.A., Loginova T.K., Avetisian G.R., Musayeva M.N., Makalova L.D. Diffuse large B cell lymphoma masked under a mixed connective tissue disease. RMJ. 2024;3:50–52.