Primary cutaneous diffuse large B-cell lymphoma, leg type, in a patient with rheumatoid arthritis undergoing etanercept therapy

Abstract

An 84-year-old woman, who was diagnosed with rheumatoid arthritis (RA) and was treated with methotrexate and, subsequently, etanercept (ETN) for 6 years, presented with rapidly progressing painful cutaneous mass on the right medial malleolus. The patient was eventually diagnosed with primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL-LT). ETN therapy was promptly discontinued expecting spontaneous regression of the lymphoma, which was thought to have developed as other iatrogenic immunodeficiency-associated lymphoproliferative disorders. However, no tumour regression was noted. Chemoimmunotherapy was subsequently initiated, which resulted in partial remission. PCLBCL-LT rarely occurs in patients with RA. Here, we report the first case of PCLBCL-LT that developed in a patient with RA receiving ETN therapy.

Keywords:

• Primary cutaneous diffuse large B-cell lymphoma leg type
• rheumatoid arthritis
• tumour necrosis factor inhibitor
• etanercept
• other iatrogenic immunodeficiency-associated lymphoproliferative disorders

Patient consent

Written informed consent for the publication of this case report was obtained from the relatives of the patient.

Ethical approval

Not applicable.

Conflict of interest

None.