Abstract
Skeletal involvement is described in 25% of patients with non-Hodgkin’s lymphoma, typically as secondary, rarely as primary lymphoma of bone. Joint infiltration is very rare and monoarthritis can be a secondary synovial reaction to adjacent bone disease or direct synovial involvement. We describe an unusual case of monoarthritis of the elbow in a middle-aged man without signs and/or symptoms associated with malignancy and with no previous rheumatic disease. Synovial biopsy revealed a diffuse infiltrate of large atypical lymphocytic B cells diagnosed by morphological and immunohistochemical findings as a malignant lymphoma. Staging procedures including total body CT scan, bone marrow biopsy, technetium-99m methylene diphosphonate bone scintigraphy were normal. We discuss the case and the review of literature and suggest that in the evaluation of patients with an unclassified arthritis, synovial or bone biopsy should be strongly considered.
This is a preview of subscription content, log in via an institution to check access.
References
Mariette X, de Roquancourt A, d'Agay MF, Gisselbrecht C, Clauvel JP, Oksenhendler E (1988) Monoarthritis revealing non-Hodgkin's T cell lymphoma of the synovium. Arthritis Rheum 31:571–572
Rice DM, Semble E, Ahl ET, Bohrer SP, Rothberger H (1984) Primary lymphoma of bone presenting as monoarthritis. J Rheumatol 11:851–854
Dorfman HD, Siegal HL, Perry MC, Oxwnhandler R (1987) Non-Hodgkin's lymphoma of the synovium simulating rheumatoid arthritis. Arthritis Rheum 30:155–161
Birlik M, Akar S, Onen F, Ozcan MA, Bacakoglu A, Ozkal S, Manisali M, Akkoc N (2004) Articular, B-cell, non-Hodgkin's lymphoma mimicking rheumatoid arthritis: synovial involvement in a small hand joint. Rheumatol Int 24:169–172
Menon N, Madhok R (1994) Symmetrical polyarthritis is not always rheumatoid. Ann Rheum Dis 53:631–632
Emkey RD, Ragsdale BD, Ropes MW, Miller W (1973) A case of lymphoproliferative disease presenting as juvenile rheumatoid arthritis. Diagnosis by synovial fluid examination. Am J Med 54:825–828
Daneshpouy M, Bataille D, Rivet J, Riviere O, Morel P, Amouroux J, Briere J, Sigaux F, Janin A (2002) Peripheral T-cell lymphoma with eosinophilia presenting as monoarthritis: a case study. Leuk Lymphoma 43:1875–1879
Peeva E, Davidson A, Kelser HD (1999) Synovial non-Hodgkin's lymphoma in a human immunodeficency virus infected patient. J Rheumatol 26:696–698
Bagga S, Gupta SM, Johns W (1996) Scintigraphic detection of a disseminated synovial lymphoma in a postrenal transplant patient. Clin Nucl Med 21:615–618
Jamieson KA, Beggs I, Robb JE (1998) Synovial presentation of non-Hodgkin's lymphoma. Br J Radiol 71:980–982
Khan SY, Hutchinsohn DG (2004) Primary synovial non-Hodgkin's lymphoma in association with ankylosing spondylitis. Rheumatology (Oxford) 43:391
Haasa KK, Durk H, Baumbach A, Saal J, Wehrmann M (1990) Non-Hodgkin's lymphoma presenting as knee monoarthritis with a popliteal cyst. J Rheumatol 17:1252–1254
Tiwari I, Thomas DR, Pathy MS, Clement DA (1982) Non-Hodgkin's lymphoma presenting in synovial membrane. Br J Clin Pract 36:327–328
Adunsky A, Yaretzky A, Klajman A (1980) Malignant lymphoma presenting as sternoclavicular joint arthritis. Arthritis Rheum 23:1330–1331
Jawa A, Lieberman AE, Alexieva CC, Jupiter JB (2006) Primary intra-articular non-Hodgkin's lymphoma of the elbow. A case report. J Bone Joint Surg Am 88:2730–2734
Disclosures
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Neri, R., Giorgetti, M., Zampa, V. et al. Case report. Elbow monoarthritis revealing B cell non-Hodgkin’s lymphoma. Clin Rheumatol 32 (Suppl 1), 111–114 (2013). https://doi.org/10.1007/s10067-010-1578-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-010-1578-0