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Chronic lymphocytic leukemia/small lymphocytic lymphoma presenting as septic arthritis of the shoulder

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Abstract

We report a case of a 53-year-old man presenting with shoulder pain mimicking septic arthritis. Laboratory findings were atypical. Biopsy performed to assess for possible osteomyelitis demonstrated chronic lymphocytic leukemia/small lymphocytic lymphoma. Intra-articular lymphoma is a rare but important consideration in patients with atypical clinical presentation. Imaging alone may be insufficient to render diagnosis as lymphoma can mimic infection, synovial hypertrophic processes, and depositional arthropathy.

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References

  1. Jawa A, Lieberman AE, Alexieva CC, Jupiter JB. Primary intra-articular non-Hodgkin’s lymphoma of the elbow. A case report. J Bone Joint Surg Am 2006; 88 (12): 2730–2734.

    Article  Google Scholar 

  2. Inamdar KV, Bueso-Ramos CE. Pathology of chronic lymphocytic leukemia: an update. Ann Diagn Pathol 2007; 11 (5): 363–389.

    Article  Google Scholar 

  3. White LM, Schweitzer ME, Khalili K, Howarth DJ, Wunder JS, Bell RS. MR imaging of primary lymphoma of bone: variability of T2-weighted signal intensity. AJR Am J Roentgenol 1998; 170 (5): 1243–1247.

    Article  CAS  Google Scholar 

  4. Guven GS, Solak Y, Unal O, Ozcakar L. Non-Hodgkin’s lymphoma among the gamut of differential diagnoses for shoulder pain. Rheumatol Int 2005; 25 (7): 565–566.

    Article  Google Scholar 

  5. Dorfman HD, Siegel HL, Perry MC, Oxenhandler R. Non-Hodgkin’s lymphoma of the synovium simulating rheumatoid arthritis. Arthritis Rheum 1987; 30 (2): 155–161.

    Article  CAS  Google Scholar 

  6. Morton LM, Wang SS, Devesa SS, Hartge P, Weisenburger DD, Linet MS. Lymphoma incidence patterns by WHO subtype in the United States, 1992–2001. Blood 2006; 107 (1): 265–276.

    Article  CAS  Google Scholar 

  7. Redaelli A, Laskin BL, Stephens JM, Botteman MF, Pashos CL. The clinical and epidemiological burden of chronic lymphocytic leukaemia. Eur J Cancer Care (Engl) 2004; 13 (3): 279–287.

    Article  CAS  Google Scholar 

  8. Cerroni L, Zenahlik P, Hofler G, Kaddu S, Smolle J, Kerl H. Specific cutaneous infiltrates of B-cell chronic lymphocytic leukemia: a clinicopathologic and prognostic study of 42 patients. Am J Surg Pathol 1996; 20 (8): 1000–1010.

    Article  CAS  Google Scholar 

  9. Hamblin T. Chronic lymphocytic leukaemia: one disease or two? Ann Hematol 2002; 81 (6): 299–303.

    Article  CAS  Google Scholar 

  10. Khan SY, Hutchinson DG. Primary synovial non-Hodgkin’s lymphoma in association with ankylosing spondylitis. Rheumatology (Oxford) 2004; 43 (3): 391.

    Article  CAS  Google Scholar 

  11. Ellis ME, el-Ramahi KM, al-Dalaan AN. Tuberculosis of peripheral joints: a dilemma in diagnosis. Tuber Lung Dis 1993; 74 (6): 399–404.

    Article  CAS  Google Scholar 

  12. Swan A, Amer H, Dieppe P. The value of synovial fluid assays in the diagnosis of joint disease: a literature survey. Ann Rheum Dis 2002; 61 (6): 493–498.

    Article  CAS  Google Scholar 

  13. Mileti J, Mileti L, Kaeding C. Non-Hodgkin’s lymphoma of the knee diagnosed by arthroscopy. Arthroscopy 2007; 23 (4): 447 e441–447 e444.

    Article  Google Scholar 

  14. Tiwari I, Thomas DR, Pathy MS, Clement DA. Non-Hodgkin’s lymphoma presenting in synovial membrane. Br J Clin Pract 1982; 36 (9): 327–328.

    CAS  PubMed  Google Scholar 

  15. Arredondo J, Worland RL, Sinnenberg RJ Jr, Qureshi GD. Non-Hodgkin’s lymphoma as an unexpected diagnosis in a shoulder arthroplasty. J Arthroplast 1999; 14 (1): 108–111.

    Article  CAS  Google Scholar 

  16. Peterfy CG, Majumdar S, Lang P, van Dijke CF, Sack K, Genant HK. MR imaging of the arthritic knee: improved discrimination of cartilage, synovium, and effusion with pulsed saturation transfer and fat-suppressed T1-weighted sequences. Radiology 1994; 191 (2): 413–419.

    Article  CAS  Google Scholar 

  17. Hughes TH, Sartoris DJ, Schweitzer ME, Resnick DL. Pigmented villonodular synovitis: MRI characteristics. Skelet Radiol 1995; 24 (1): 7–12.

    Article  CAS  Google Scholar 

  18. Narvaez JA, Narvaez J, Ortega R, De Lama E, Roca Y, Vidal N. Hypointense synovial lesions on T2-weighted images: differential diagnosis with pathologic correlation. AJR Am J Roentgenol 2003; 181 (3): 761–769.

    Article  Google Scholar 

  19. Karchevsky M, Schweitzer ME, Morrison WB, Parellada JA. MRI findings of septic arthritis and associated osteomyelitis in adults. AJR Am J Roentgenol 2004; 182 (1): 119–122.

    Article  Google Scholar 

  20. Rutten MJ, van den Berg JC, van den Hoogen FH, Lemmens JA. Nontuberculous mycobacterial bursitis and arthritis of the shoulder. Skelet Radiol 1998; 27 (1): 33–35.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. NYU Hospital for Joint Diseases, 6th Floor, Room 600, 301 E. 17th Street, New York, NY, 10003, USA

    Andrea Donovan, Mark E. Schweitzer & George Nomikos

  2. Bellevue Hospital Center, NBV 4th 4W35, 462 First Avenue, New York, NY, 10016, USA

    Roberto A. Garcia

Authors
  1. Andrea Donovan
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  2. Mark E. Schweitzer
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  3. Roberto A. Garcia
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  4. George Nomikos
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Correspondence to Andrea Donovan.

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Donovan, A., Schweitzer, M.E., Garcia, R.A. et al. Chronic lymphocytic leukemia/small lymphocytic lymphoma presenting as septic arthritis of the shoulder. Skeletal Radiol 37, 1035–1039 (2008). https://doi.org/10.1007/s00256-008-0512-x

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  • DOI: https://doi.org/10.1007/s00256-008-0512-x

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