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Case Records of the Massachusetts General Hospital
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Volume 358:1838-1848 April 24, 2008 Number 17
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Case 13-2008 — A 46-Year-Old Man with Rheumatoid Arthritis and Lymphadenopathy
Nikhil C. Munshi, M.D., Subba Digumarthy, M.D., and Aliyah Rahemtullah, M.D.

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Presentation of Case

Viviany Taqueti (Harvard Medical School): A 46-year-old man was seen in the hematology–oncology clinic of a cancer center affiliated with this hospital because of anorexia and generalized lymphadenopathy.

The patient had a history of rheumatoid arthritis but had been otherwise well until 1 month earlier, when diffuse lymphadenopathy gradually developed in his neck, axillae, and groin, associated with sore throat and loss of appetite but not with weight loss. Approximately 1 week before this evaluation, fatigue, nausea, bloating, loose stools, and a cough productive of white sputum developed. On examination by his primary care physician 5 days before this evaluation, . . . [Full Text of this Article]

Differential Diagnosis

Indolent Lymphomas

Aggressive Lymphomas

Infections

Castleman's Disease

Monoclonal Gammopathy

Gamma Heavy-Chain Disease

Clinical Diagnosis

Dr. Nikhil C. Munshi's Diagnosis

Pathological Discussion

Anatomical Diagnosis


Source Information

From the Boston Veterans Affairs Healthcare System and the Jerome Lipper Center for Multiple Myeloma, Dana–Farber Cancer Institute (N.C.M.); the Departments of Radiology (S.D.) and Pathology (A.R.), Massachusetts General Hospital; and the Departments of Medicine (N.C.M.), Radiology (S.D.), and Pathology (A.R.), Harvard Medical School — all in Boston.



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