Clinical images: Solitary extranodal malignant lymphoma of the forearm in rheumatoid arthritis.

摘要

The patient, a 57-year-old woman with longstanding rheumatoid arthritis (RA), presented with a nontender nodule on her left forearm that had progressively increased in size over several months. Her RA was in complete remission after 18 months of etanercept treatment, in combination with oral pulse methotrexate at a dosage of 10 mg/week. Magnetic resonance imaging (MRI) of her left forearm revealed a lesion with high signal intensity in the extensor muscles on T2-weighted, fat-suppressed images, suggesting myositis or extranodal lymphoma (A). An open biopsy was performed, and histopathologic examination revealed a diffuse large B cell lymphoma.