A case of adult-onset Still's disease complicated by non-Hodgkin's lymphoma

Left cervical lymphadenopathy developed in a 50-year-old male who had a his tory of adult-onset Still's disease for the preceding 18 months. Still's di sease is characterized by rash, fever, and leukocytosis. Lymphadenopathy ha s been reported in about 60% of the patients, and most histopathologic stud ies have shown non-specific reactive hyperplasia. However, in this case, an open biopsy of the cervical node revealed a histology of diffuse large B-c ell lymphoma. The B-cell malignant lymphoma that developed may have resulte d from a sequential progression of a previous stage of benign lymphoprolife rative lesion. Our case suggests that the pathophysiology of adult-onset St ill's disease involves the stimulation of lymphoid systems to the point of progression towards lymphoma. Malignant lymphoma should be added to the lis t of life-threatening complications which, although rare, are associated wi th this disease.