P1-32-1 - Non-Hodgkin'S Lymphoma of the Peripheral T Cell Type Complicating Scleroderma

Abstract

Object: Cases of concomitant collagen disease and malignant tumor have been reported, but the complication of systemic sclerosis (SSc) by malignant tumor has still small number. We encountered a patient who developed non-Hodgkin's lymphoma peripheral T cell type after the diagnosis of localized scleroderma.Case description: The patient was a 38-year-old woman who had been diagnosed with localized scleroderma. During physical examination at admission, clubbed and sausage-like fingers and Reynaud's symptoms were noted. Abdominal CT revealed marked hepatomegaly and splenoma and swelling of multiple peritoneal lymph nodes. For which cervical lymph node biopsy was performed, and revealed peripheral T cell lymphoma. Eight cycles of CHOP therapy were planned and initiated. The cough disappeared rapidly after the completion of CHOP therapy, and the skin pruritus was alleviated. Currently, the patient finished treatment at the outpatient clinic.Discussion: The association between SSc and malignant tumors remains unclear. According to the studies reported by Abu-Shakra et al. and Rosenthal, the complication of SSc by visceral malignant tumor does not occur incidentally. Increased incidences of lung cancer, breast cancer, and lymphatic proliferative disease have been reported in SSc patients. While there is no specific tendency for the site of development of malignant tumors complicating dermatomyositis and multiple myositis, the rate of complication by ML are reportedly rare. Regarding the mechanism of complication of SSc by ML, the involvement of both B cell clonal development and T lymphocyte activation-based abnormal cellular immunity have been suggested. The development of SSc as a paraneoplastic syndrome has also been considered. This patient developed lymphoma 22 months after the diagnosis of SSc, which is considered relatively early.