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Rheumatoid arthritis and B cell lymphoma with pathological changes of reactive histiocytosis.
  1. M Shimada,
  2. M Kojima,
  3. G Tani,
  4. S Komatsumoto,
  5. M Nara
  1. Department of Internal Medicine, Ashikaga Red Cross Hospital, Tochigi, Japan.

    Abstract

    A 67 year old woman with rheumatoid arthritis was admitted to hospital in acute renal failure. Her clinical features included increasing dyspnoea and oedema, and a computed tomogram of the abdomen showed a large mass in the retroperitoneum. Twenty six days later, she died, and a post mortem examination was carried out. The histological changes of the mass indicated B cell lymphoma of diffuse large cell type, with a reactive proliferation of erythrophagocytosing histiocytes. Immunocytochemical studies showed that the histiocytes were positive for CD-68 and lysozyme, but negative for S-100 protein. Such neoplastic B cell proliferation accompanied by activation of benign looking histiocytes with erythrophagocytosis is very rare.

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