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Which malignancies are associated with preexisting CTD?
Malignancies associated with preexisting connective tissue diseases are outlined in the below table
Preexisting CTD Associated with Malignancy
| Disease (Risk) | Malignancy | Clinical Risks |
|---|---|---|
| Rheumatoid arthritis | Lymphoproliferative disorders (2–3 times increased risk) Lung cancer (2 times increased risk) Melanoma and other skin cancers | Longer disease duration, high disease activity immunosuppression, Felty’s syndrome |
| Systemic lupus erythematosus | Lymphoproliferative disorders (2–4 times increased risk) Cervical cancer | Adenopathy, ↑ spleen HPV-related |
| Discoid lupus | Squamous cell epithelioma | In plaques >20 years |
| Sjögren’s syndrome (1.5×) | Lymphoproliferative disorders, hematologic malignancies (4%–10% lifetime risk) | Palpable purpura, cutaneous ulcers, cryoglobulinemia, adenopathy, ↑ spleen, germinal centers MSG |
| Systemic sclerosis (1.4×) | Alveolar cell carcinoma, nonmelanoma skin cancer, adenocarcinoma of esophagus, lymphoproliferative disorders | Pulmonary fibrosis, areas of skin fibrosis, Barrett’s metaplasia, anti-RNAP III |
| DM (4× to 7×) | Adenocarcinoma, melanoma, lymphoproliferative disorders, nasopharyngeal tumors (Asians) | Older age, ulcerative skin lesions, anti-p155/p140, anti-NXP-2 |
| PM (1.6×) | Adenocarcinoma | PM < DM |
| ANCA vasculitis (1.7×) | Various cancers | Some due to cyclophosphamide |
| Paget’s disease | Osteogenic sarcoma | Occurs in 1% of lesions |
| Eosinophilic fasciitis | Lymphoproliferative disorders | Aplastic anemia, thrombocytopenia |
ANCA, Antineutrophil cytoplasmic antibody; HPV, human papillomavirus; MSG, minor salivary gland biopsy.
