PDF(Pubmed)
Abstract：
A man with polycystic kidney disease and a history of renal transplantation at the age of 55 years developed seronegative rheumatoid arthritis (RA) at the age of 68 years. Treatment with a biological derivative led to remission; however, the patient relapsed 2 years later. After being switched to baricitinib, the patient again achieved remission. After 2 years, when the patient was aged 72 years, RA recurred, and the right native kidney became enlarged due to the presence of a large tumor. Surgical nephrectomy was performed, and the tumor was classified as renal cell carcinoma (RCC), not otherwise specified. The cancer tissue comprised sarcomatoid and rhabdoid cells with marked neutrophil infiltration, and the tumor cells were positive for interleukin-6. The patient, aged 73 years, experienced a resolution of joint pain following surgical intervention; however, they died because of systemic metastases ~10 weeks post-operation. Based on the clinical course, the RA-like lesions and subsequent RCC were considered to represent a paraneoplastic syndrome.
摘要：
一名患有多囊肾病并在55岁时有肾移植史的男子在68岁时发展为血清阴性的类风湿性关节炎（RA）。用生物衍生物治疗导致缓解；然而，患者在2年后复发。改用baricitinib后,患者再次获得缓解。两年后,当病人72岁时，RA复发,右侧天然肾脏因存在大肿瘤而增大。进行了手术肾切除术，肿瘤被归类为肾细胞癌（RCC），未指定。癌组织包括肉瘤样和横纹肌样细胞，有明显的中性粒细胞浸润，肿瘤细胞白细胞介素-6阳性。病人,73岁,在手术干预后经历了关节疼痛的缓解；然而，他们死于全身转移，术后10周。根据临床过程，RA样病变和随后的RCC被认为是副肿瘤综合征.
