Question:medium
Which is the most common malignancy associated with rheumatoid arthritis?
Which is the most common malignancy associated with rheumatoid arthritis?
Show Hint
Think of the malignancy that overlaps with Felty syndrome in RA.
Updated On: Jun 24, 2026
- Diffuse large B cell lymphoma
- Large granular lymphocytic leukemia
- Chronic lymphocytic leukemia
- None of the above
Show Solution
The Correct Option is B
Solution and Explanation
Step 1: Long-standing rheumatoid arthritis keeps the immune system in an activated state. This ongoing antigenic drive favours abnormal clonal growth of lymphocytes over time.
Step 2: Among the lymphoid cancers, the one repeatedly tied to RA is large granular lymphocytic leukemia, a clonal increase of cytotoxic lymphocytes that frequently coexists with the Felty-type picture of low neutrophils and an enlarged spleen.
Step 3: When the reactive granular lymphocyte proliferation seen in some RA patients becomes clonal, it crosses over into LGL leukemia, explaining the recurrent infections from neutropenia in these cases.
Step 4: The other listed cancers, namely diffuse large B cell lymphoma and chronic lymphocytic leukemia, are not the signature RA-linked malignancy, so they are set aside.
\[\boxed{\text{Large granular lymphocytic leukemia}}\]
Step 2: Among the lymphoid cancers, the one repeatedly tied to RA is large granular lymphocytic leukemia, a clonal increase of cytotoxic lymphocytes that frequently coexists with the Felty-type picture of low neutrophils and an enlarged spleen.
Step 3: When the reactive granular lymphocyte proliferation seen in some RA patients becomes clonal, it crosses over into LGL leukemia, explaining the recurrent infections from neutropenia in these cases.
Step 4: The other listed cancers, namely diffuse large B cell lymphoma and chronic lymphocytic leukemia, are not the signature RA-linked malignancy, so they are set aside.
\[\boxed{\text{Large granular lymphocytic leukemia}}\]
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