Methotrexate-associated lymphoproliferative disorders in the central nervous system and stomach A case report

被引：2

作者：

Kawazoe, Mai ^{[1
]}

Kaneko, Kaichi ^{[1
]}

Nanki, Toshihiro ^{[1
]}

机构：

[1] Toho Univ, Div Rheumatol, Dept Internal Med, Sch Med,Fac Med,Ota Ku, 11-1 Omori Nishi, Tokyo 1438541, Japan

来源：

MEDICINE | 2020年 / 99卷 / 15期

关键词：

central nervous system lymphoma; methotrexate; methotrexate-associated lymphoproliferative disorder; rheumatoid arthritis; EPSTEIN-BARR-VIRUS; RHEUMATOID-ARTHRITIS; DOSE METHOTREXATE; LYMPHOMA; PATIENT;

D O I：

10.1097/MD.0000000000019850

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Rationale: Methotrexate-associated lymphoproliferative disorder (MTX-LPD) is a serious complication in patients treated using methotrexate. It occasionally develops in extra-nodal sites, but rarely in the central nervous system (CNS) or in 2 different sites at the same time. We present the rare case of a patient with rheumatoid arthritis who developed lymphoma in the CNS and stomach during MTX therapy. Patient concerns: A 75-year-old Japanese man with rheumatoid arthritis who received methotrexate was admitted to our hospital because of gait ataxia and anorexia. Diagnoses: Imaging findings and biopsy led to a diagnosis of 2 different types of MTX-LPD in the central nervous system and stomach. Interventions: The lesion in his stomach improved after methotrexate withdrawal, whereas the cerebellar mass required highdose methotrexate and rituximab therapy. Outcomes: Complete remission has been maintained for the 2 years following the initiation of chemotherapy. Lessons: In patients with RA who receive MTX and develop new neurological symptoms, CNS lymphoma as an MTX-LPD may be considered as a differential diagnosis.

引用

页数：4

共 16 条

[11] Spontaneous remission of "methotrexate-associated lymphoproliferative disorders" after discontinuation of immunosuppressive treatment for autoimmune disease. Review of the literature [J].