Previous reports have stressed the association of autoimmune disturbances and lymphoproliferative neoplasms. Here the coexistence of rheumatoid arthritis and plasma cell or lymphocytic neoplasms was investigated. An increased incidence is suggested, as 4 cases of rheumatoid arthritis were found among 112 cases of plasma cell and lymphocytic neoplasms.
ECENT REPORTS have suggested a causal denstrom's macroglobulinemia had had an-R relationship between "autoimmune" tecedent rheumatoid arthritis. An additional disorders, such as rheumatoid arthritis, 32 sera from patients with lymphoma were disseminated lupus erythematosus, and studied; 5 contained a monoclonal immuno-Sjogren's syndrome, and lymphoprolifera-globulin, and one of the 5 patients also had tive neoplasms.1-6 One hypothesis has been had rheumatoid arthritis. that in connective tissue disorders there is a chronic state of immunologic hyperactivity and lymphocytic proliferation which on occasion may progress to frank malignant l y m p h ~m a . ~~~* ~
A second hypothesis suggests that a clone of malignant lymphoid cells may arise by somatic mutation, which is capable of forming antibody to various normal tissue antigens with the eventual clinical appearance of "autoimmune" phenomena.lV6 Finally, Millers has suggested that these patients may be susceptible to both an "autoimmune" disorder and malignant lymphoma.
The coexistence of rheumatoid arthritis and the plasma cell neoplasms, multiple myeloma and macroglobulinemia, is the subject of this report. Three patients from 80 cases of plasma cell neoplasia and Wal-
METHODS AND MATERIALS