Rituximab Monotherapy for Grade 2-3 Lymphomatoid Granulomatosis with Central Nervous System Involvement in a Patient Receiving Methotrexate for Rheumatoid Arthritis

Lymphomatoid granulomatosis (LYG) is a rare lymphoproliferative disorder (LPD). The optimal management strategy of methotrexate (MTX) related-LPD with central nervous system (CNS) involvement and histological features of LYG remains unclear. We herein report a case of grade 2-3 LYG in a rheumatoid a...

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Detalles Bibliográficos
Autores principales: Hosoi, Hiroki, Tanaka, Ken, Sakaki, Ayaka, Kosako, Hideki, Iwamoto, Ryuta, Matsumoto, Ai, Arakawa, Fumiko, Yamoto, Toshikazu, Murata, Shogo, Mushino, Toshiki, Murata, Shin-Ichi, Nakao, Naoyuki, Ohshima, Koichi, Sonoki, Takashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2022
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10372291/
https://www.ncbi.nlm.nih.gov/pubmed/36418093
http://dx.doi.org/10.2169/internalmedicine.0636-22
Descripción
Sumario:Lymphomatoid granulomatosis (LYG) is a rare lymphoproliferative disorder (LPD). The optimal management strategy of methotrexate (MTX) related-LPD with central nervous system (CNS) involvement and histological features of LYG remains unclear. We herein report a case of grade 2-3 LYG in a rheumatoid arthritis patient, in which an intracranial mass accompanied by hemorrhaging and pulmonary and skin lesions developed. The patient received successful rituximab monotherapy. The tumor cells in the skin and brain showed monoclonal and oligoclonal proliferation, respectively. Our case suggests that rituximab monotherapy may be effective against MTX-LPD with CNS involvement, especially in cases with LYG histology.

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