Lymphoproliferative disorder of nasopharynx after long-standing cyclosporin therapy for psoriatic arthritis.
BACKGROUND
The increased risk of developing lymphoproliferative disorders, mainly linked with Epstein-Barr virus infection, is well documented in patients with cyclosporin-induced immunosuppression following organ transplantation. Lymphoproliferative disease is extremely rare in the non-transplant setting.


METHODS
We present the first published case of non-Epstein-Barr virus associated lymphoproliferative disease in a patient receiving long-standing cyclosporin therapy for psoriatic arthritis, which presented as a recurrent nasopharyngeal mass.


RESULTS
Histological examination showed lymphoid hyperplasia in repeated biopsies. Macroscopic clearance was persistently followed by aggressive recurrence. Spontaneous regression occurred upon cyclosporin withdrawal.


CONCLUSIONS
This rare complication of cyclosporin therapy in non-transplant patients is highlighted from an otolaryngological perspective, as the sole presentation may be a recurrent nasopharyngeal mass. Repeated biopsies showing lymphoid hyperplasia, together with aggressive recurrence, should prompt immediate drug withdrawal to reduce immunosuppression and promote spontaneous regression.
Leong
A C
AC
Department of Otolaryngology, University Hospital Lewisham, London, UK. ackleong@gmail.com
Yong
J
J
Salama
N
N
D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D001706:Biopsy; D003524:Cyclosporins / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology / Q000601:surgery; D009302:Nasopharyngeal Diseases / Q000139:chemically induced*; D012008:Recurrence; D012075:Remission, Spontaneous; D012086:Reoperation
D003524:Cyclosporins; D007166:Immunosuppressive Agents