A transient benign lymph node-based proliferation of T-cells simulating non-Hodgkin lymphoma in a patient with psoriasis treated with tumor necrosis factor alpha and CD11a antagonists

BACKGROUND Therapeutic biologic agents are uncommonly associated with lymphoma. CASE PRESENTATION We report a patient with psoriasis treated with the biologic agents efalizumab (Raptiva) and etanercept (Enbrel), who developed painless lymphadenopathy with peripheral lymphocytosis during treatment, simulating a non-Hodgkin lymphoma clinically and pathologically. Lymphocytosis and lymphadenopathy spontaneously remitted following cessation of etanercept therapy and have not recurred. CONCLUSION Distinction between clinically benign lymphoid proliferations related to anti-psoriasis therapy and malignant lymphoma avoids the unnecessary use of anti-lymphoma chemotherapy.