Progressive systemic sclerosis preceded by malignant lymphoma

Multicentric B-cell lymphoma with presumed paraneoplastic generalized cutaneous sclerosis in a dog

BACKGROUND

Reports of dermal sclerosis in dogs include scleroderma or morphea of unknown cause, cicatricial alopecia and congenital/hereditary fibrosis.

CLINICAL SUMMARY

A 12-year-old, male castrated chihuahua-mix dog was evaluated for skin lesions of unknown duration. The dog had severe alopecia, skin thickening and marked peripheral lymphadenopathy. Lymph node cytological investigation, immunohistochemical investigation and clonality testing demonstrated an intermediate to large B-cell lymphoma. The thickened skin had severe collagen deposition, effacing adnexal structures. The dog's lymphoma was treated but the skin lesions remained unchanged. The dog was euthanized.

CONCLUSIONS AND CLINICAL IMPORTANCE

To the best of the authors' knowledge, this is the first report of multicentric B-cell lymphoma in a dog with concurrent diffuse cutaneous sclerosis, similar to a human paraneoplastic reaction.

Non-Hodgkin's lymphoma in systemic sclerosis: case and literature review

The occurrence of non-Hodgkin's lymphoma in systemic sclerosis is an uncommon event. In our scleroderma cohort, a case of primary gastric B-cell lymphoma was diagnosed in 2007. The patient was a 45-year-old woman suffering from late systemic sclerosis sine scleroderma in whom non-Hodgkin's lymphoma presented with progressive weight loss, later with gastrointestinal symptoms. Subsequently, we retrospectively analyzed the charts of 251 systemic sclerosis patients consecutively admitted to our Unit from 2000 to 2008 to search for other non-Hodgkin's lymphoma cases (prevalence, 0.49%). Then we performed a Pubmed search for "systemic sclerosis & non-Hodgkin's lymphoma," limited to the English language. Twenty detailed cases of such an association were found, pointing out the following: non-Hodgkin's lymphoma seems to be associated to old age, female sex, diffuse cutaneous subset and early disease; B-cell lymphoma subtypes are the majority; the interval between systemic sclerosis and lymphoma onset is usually short; systemic sclerosis could present as a paraneoplastic syndrome in some cases. We concluded that, although rare, the association of systemic sclerosis and non-Hodgkin's lymphoma may not be coincidental and the clinician should be aware of the risk for lymphoproliferative disorders in scleroderma patients. This is the first description of non-Hodgkin's lymphoma in systemic sclerosis sine scleroderma. The insidious onset of gastric lymphomas, mimicking the most common features of gastrointestinal involvement in systemic sclerosis is underlined.

Mucosa-associated lymphoid tissue lymphoma (MALT) of salivary glands and scleroderma: a case report

The connection between scleroderma and lymphoma is uncommon and its pathogenic relationship is a much debated subject. We describe the case of a patient with mucosa-associated lymphoid tissue lymphoma (MALT) of both parotid glands without clinical signs of Sjögren's syndrome who simultaneously developed scleroderma. Independently of the pathogenic mechanism of these two diseases, it seems very important to emphasize that scleroderma may be the first manifestation of lymphoma.