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Lymphoproliferative disorder of nasopharynx after long-standing cyclosporin therapy for psoriatic arthritis

Published online by Cambridge University Press:  07 April 2010

A C Leong ,
J Yong  and
N Salama
A C Leong*
Affiliation:
Department of Otolaryngology, University Hospital Lewisham, London, UK
J Yong
Affiliation:
Department of Otolaryngology, University Hospital Lewisham, London, UK
N Salama
Affiliation:
Department of Otolaryngology, University Hospital Lewisham, London, UK
*
Address for correspondence: Ms AC Leong, Department of Otolaryngology, University Hospital Lewisham, London SE13 6LH, UK. Fax: +44 (0)20 8333 3192 E-mail: ackleong@gmail.com
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Abstract

Background:

The increased risk of developing lymphoproliferative disorders, mainly linked with Epstein–Barr virus infection, is well documented in patients with cyclosporin-induced immunosuppression following organ transplantation. Lymphoproliferative disease is extremely rare in the non-transplant setting.

Methods:

We present the first published case of non-Epstein–Barr virus associated lymphoproliferative disease in a patient receiving long-standing cyclosporin therapy for psoriatic arthritis, which presented as a recurrent nasopharyngeal mass.

Results:

Histological examination showed lymphoid hyperplasia in repeated biopsies. Macroscopic clearance was persistently followed by aggressive recurrence. Spontaneous regression occurred upon cyclosporin withdrawal.

Conclusion:

This rare complication of cyclosporin therapy in non-transplant patients is highlighted from an otolaryngological perspective, as the sole presentation may be a recurrent nasopharyngeal mass. Repeated biopsies showing lymphoid hyperplasia, together with aggressive recurrence, should prompt immediate drug withdrawal to reduce immunosuppression and promote spontaneous regression.

Keywords

Lymphoproliferative DisorderNasopharynxPsoriasisCyclosporin
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 10 , October 2010 , pp. 1120 - 1122
Copyright
Copyright © JLO (1984) Limited 2010

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