Rheumatic manifestations of neoplasia

Recent literature on the rheumatic manifestations of neoplasia has again focused on the increased association of Sjögren's syndrome and rheumatoid arthritis with lymphoproliferative malignancies and leukemias. A series of 13 patients with monocytoid B-cell lymphoma, a recently described variant of low-grade B-cell lymphoma, and Sjögren's syndrome was reported. The skeletal manifestations of leukemias are extensively reviewed emphasizing that osteoarticular manifestations may predate the hematologic disease. A case of monoarthritis of the knee as a manifestation of chronic leukemia is presented in which synovial biopsy revealed a leukemic infiltrate. Recent studies looking at the association of polymyositis and dermatomyositis with malignancy challenge this link. Two cases of malignancy presenting with polyarthritis are reviewed, and in both cases the polyarthritis resolved with removal of the tumor. A case report and a series of synovial sarcomas are also reviewed. Hodgkin's disease can initially present with skeletal involvement; six cases are reviewed.