炎症性背痛是脊柱关节炎的一个特征。然而，它并不是炎症性风湿性疾病的唯一症状，因为它也可能与非炎症实体相关。罕见情况下，其病因可在恶性淋巴瘤等肿瘤性疾病中找到。即使存在表明潜在风湿性疾病的合并症，如寻常型银屑病，临床医生也不应误入歧途。必须注意矛盾的发现，因为治疗方法因诊断而异。在此，我们报告了一名银屑病患者，该患者表现出特征性的炎症性背痛和欺骗性的影像学结果。虽然该患者最初被认为患有轴性炎症性风湿性疾病，但伴随的非典型情况，特别是她的年龄，立即对轴性银屑病关节炎的诊断提出了挑战。她最终被诊断出患有 IV 期滤泡性淋巴瘤，表现为罕见且完全结外病变和脊柱关节炎样形态。该病例有效地证明了彻底诊断检查的重要性，以及在面对炎症性背痛时应如何考虑某些临床因素，例如患者的年龄。版权所有 © 2024，Ullrich 等人。

Inflammatory back pain is a characteristic of spondyloarthritis. It is not, however, an exclusive symptom of inflammatory rheumatic diseases as it can also be associated with non-inflammatory entities. Infrequently, the etiology can be found in neoplastic conditions such as malignant lymphoma. Even in the presence of comorbidities indicatory of underlying rheumatic disease, like psoriasis vulgaris, the clinician should not be led astray. It is essential to pay attention to contradictory findings, as treatment crucially differs depending on diagnosis. Herein, we report on a psoriasis patient who presented with characteristic inflammatory back pain and deceptive imaging results. While the patient was initially thought to suffer from an inflammatory rheumatic disease with axial involvement, it was the accompanying atypical circumstances, particularly her age, that instantly challenged the diagnosis of axial psoriatic arthritis. She was eventually diagnosed with stage IV follicular lymphoma that manifested with rare and exclusively extranodal lesions and spondyloarthritis-like morphology. This case effectively demonstrates the importance of a thorough diagnostic workup and how certain clinical factors, such as the patient's age, should be considered when confronted with inflammatory back pain.Copyright © 2024, Ullrich et al.