Polymyalgia Rheumatica Revealing a Lymphoma: A Two-Case Report

Abstract EN

Introduction.

Polymyalgia rheumatica (PMR) is one of the most common inflammatory rheumatism types in elderly population.

The link between cancer and PMR is a matter of debate.

Methods.

We report two cases of PMR leading to the diagnosis of lymphoma and the growing interest of PET-TDM in this indication.

Results.

A 84-year-old man known for idiopathic neutropenia presented an inflammatory arthromyalgia of the limb girdle since one month.

Blood exams highlighted the presence of a monoclonal B cell clone.

Bone marrow concluded to a B cell lymphoma of the marginal zone.

He was successfully treated with 0.3 mg/kg/d of prednisone, and response was sustained after 6 months.

A 73-year-old man known for prostatic neoplasia in remission for 5 years presented arthromyalgia of the limb girdle since one month.

PET-CT revealed bursitis of the hips and the shoulders, no prostatic cancer recurrence, and a metabolically active iliac lymphadenopathy whose pathologic exam concluded to a low grade follicular lymphoma.

He was successfully treated with 0.3 mg/kg/d of prednisone.

Conclusion.

These observations may imply that lymphoma is sometimes already present when PMR is diagnosed and PET-CT is a useful tool in the initial assessment of PMR to avoid missing neoplasia.