Diffuse arteritis, long-term immunosuppression and malignancy

A 45-year-old White man presented with multiple aneurysm formation and severe constitutional symptoms, the control of which entailed long-term corticosteroid therapy. Early in the patient's clinical course, two aneurysms were resected, and at subsequent postmortem examination the vascular lesions were found to be inactive and fibrosed, which suggested that the corticosteroids had been effective in controlling the inflammatory reaction. Of special interest was the development of diffuse lymphoma of the large cell type (histiocytic lymphoma) late in the course of the disease. This report emphasises the association between immunosuppressive therapy and subsequent neoplasia, and stresses the need for caution in the administration of these agents to patients whose condition is benign.