A centrofacial B lymphoma in a rheumatoid arthritis patient

We report on a 65-year-old man who was hospitalized for polyarthritis with deterioration of his general state of health and chronic sinusitis. Clinical and biological signs led to the diagnosis of RA associated with localized Wegener's granulomatosis. Methotrexate and corticosteroids led to a distinct improvement in the patient's articular symptoms and in his general condition. One year after the start of treatment, a tumefaction of the right maxillary sinus appeared. Scans revealed a tumoral lesion in the right maxillary sinus. This proved to be a large B-cell lymphoma. The patient received chemotherapy (CHOP) and radiotherapy. This centrofacial lymphoma may be regarded as a B lymphoma of the MALT (mucosal associated lymphoma tumor) type, mimicking a relapse of Wegener's granulomatosis. (C) 2006 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.