Abstract

Volume.118 Number.5

Original article : Case report

A Case Report of Malignant Lymphoma Receiving Infliximab Therapy with Behçet's Disease
Koh-Hei Sonoda1, Takako Fukuhara2,3, Horoshi Yoshikawa2, Atsunobu Takeda2, Takeru Yoshimura2, Mitsuteru Akahoshi4, Hirotake Kusumoto4, Kentaro Kohno4, Koji Kato4, Koichi Akashi4, Kenichi Kohashi5, Shinichi Aijima5, Kenichi Namba3, Tatsuro Ishibashi2
1 Department of Ophthalmology, Yamaguchi University Graduate School of Medicine
2 Department of Ophthalmology, Kyushu University Graduate School of Medical Sciences
3 Department of Ophthalmology, Hokkaido University Graduate School of Medicine
4 Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
5 Department of Anatomic Pathology, Kyushu University Graduate School of Medical Sciences

Background: To report a case of malignant lymphoma occurring in Behçet's disease (BD) with infliximab therapy.
Case: A 62-year-old man was diagnosed with BD in 1997. Despite treatment with colchicine, cyclosporine and prednisolone, he had frequent bilateral posterior ocular attacks. He was started on infliximab in August 2007 and for 6 months had no ocular attacks. Cyclosporine was therefore reduced. After 4 years of infliximab administration, he had neither ocular attacks nor general symptoms. However, he had general malaise and weight loss from the end of March 2012. Peripheral blood examination showed abnormal cells, so we terminated the infliximab. Bone marrow aspiration showed diffuse proliferation of medium to large lymphoid cells, and the histological diagnosis was diffuse large B-cell lymphoma. He was treated with 8 cycles of chemotherapy and 4 times intrathecal chemotherapy, and is now in remission. After termination of infliximab, he had no further ocular attacks.
Conclusion: Although malignant lymphoma associated with BD is rare, attending ophthalmologists need to keep it in mind.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 118: 440-445, 2014.

Key words
Malignant lymphoma, Infliximab, Behçet's disease
Reprint requests to
Koh-Hei Sonoda, M.D. Department of Ophthalmology, Yamaguchi University Graduate School of Medicine. 1-1-1 Minamiogushi, Ube-shi, Yamaguchi-ken 755-8505, Japan