title: Seropositive rheumatoid arthritis with dermatomyositis sine myositis, angioimmunoblastic lymphadenopathy with dysproteinemia-type T cell lymphoma, and B cell lymphoma of the oropharynx.
abstract: Angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) is a rare lymphoproliferative disorder that often progresses to high grade T cell lymphoma. We describe a 63-year-old woman with longstanding seropositive rheumatoid arthritis who developed fever, cutaneous findings of dermatomyositis, a diffuse pruritic maculopapular rash, enlarged lymph nodes, polyclonal elevated serum gammaglobulins, and an IgG lambda paraprotein. Lymph node biopsies yielded tissue with characteristic changes of AILD and T cell lymphoma. Interleukin 6 (IL-6) was present during the early, active phase of disease, and circulating IL-6 and IL-2 were detected one month before tumor recurrence. Two years after AILD and T cell lymphoma were diagnosed, she developed a B cell lymphoma that involved the oropharynx.
authors.affiliation: Harry S. Truman Memorial Veterans' Hospital, and the Department of Internal Medicine, University of Missouri, Columbia, USA.
authors.forename: M
authors.initials: M
authors.lastname: Hashefi
authors.forename: T R
authors.initials: TR
authors.lastname: McHugh
authors.forename: G P
authors.initials: GP
authors.lastname: Smith
authors.forename: T J
authors.initials: TJ
authors.lastname: Elwing
authors.forename: R W
authors.initials: RW
authors.lastname: Burns
authors.forename: S E
authors.initials: SE
authors.lastname: Walker
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000276:immunology / Q000473:pathology; D015415:Biomarkers; D001706:Biopsy; D001796:Blood Protein Disorders / Q000150:complications* / Q000473:pathology; D003882:Dermatomyositis / Q000150:complications* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000150:complications* / Q000473:pathology; D008198:Lymph Nodes; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D009960:Oropharynx / Q000473:pathology
chemical_list: D015415:Biomarkers