Polymyalgia Rheumatica Revealing a Lymphoma: A Two-Case Report

Area of Science:

• Rheumatology
• Oncology
• Nuclear Medicine

Background:

• Polymyalgia rheumatica (PMR) is a common inflammatory condition in older adults.
• The association between PMR and cancer, particularly lymphoma, is debated.
• Early diagnosis of underlying malignancy is crucial for effective patient management.

Purpose of the Study:

• To investigate the potential link between Polymyalgia rheumatica (PMR) and lymphoma.
• To highlight the utility of Positron Emission Tomography-Computed Tomography (PET-CT) in diagnosing PMR and associated malignancies.
• To present two cases of PMR preceding lymphoma diagnosis.

Main Methods:

• Case report of two elderly male patients presenting with PMR symptoms.
• Diagnostic workup included blood tests, bone marrow biopsy, and PET-CT scans.
• Treatment involved prednisone and assessment of response.

Main Results:

• Case 1: An 84-year-old man diagnosed with marginal zone B cell lymphoma after presenting with PMR symptoms.
• Case 2: A 73-year-old man diagnosed with low-grade follicular lymphoma after presenting with PMR symptoms and findings on PET-CT.
• Both patients responded well to prednisone treatment.

Conclusions:

• Lymphoma may be present at the time of PMR diagnosis.
• PET-CT is a valuable tool for the initial assessment of PMR, aiding in the detection of occult malignancies.
• Prompt diagnosis and management of associated cancers improve patient outcomes.