title: Lymphomatoid granulomatosis involving central nervous system successfully treated with rituximab alone.
abstract: OBJECTIVE
  To report the successful treatment of a patient with lymphomatoid granulomatosis (LYG), a rare Epstein-Barr virus-positive lymphoproliferative disorder, using rituximab (anti-CD20 monoclonal antibody). The prognosis for LYG has been reported to be poor, and no satisfactory treatment has been established. Because central nervous system (CNS) involvement of LYG has been known to show poor prognosis, the establishment of an effective treatment for CNS LYG with mild adverse effects is desired.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A 48-year-old Japanese man presenting with slowly progressive spastic paraparesis diagnosed as LYG involving the CNS and lungs.
  
  
  METHODS
  The patient was treated with rituximab (375 mg/m2, once weekly for 1 month) alone. Main Outcome Measure Improvement of the lesions on imaging.
  
  
  RESULTS
  The neurological signs resolved and the lesions in the CNS and lungs were mostly diminished after the rituximab monotherapy without any adverse effects. The patient stayed in remission for 18 months.
  
  
  CONCLUSIONS
  Rituximab monotherapy was effective in treating the patient; hence, rituximab should be considered as the initial treatment against LYG involving the CNS.
authors.affiliation: Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ishiura
authors.forename: Masato
authors.initials: M
authors.lastname: Morikawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Hamada
authors.forename: Takuro
authors.initials: T
authors.lastname: Watanabe
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kako
authors.forename: Shigeru
authors.initials: S
authors.lastname: Chiba
authors.forename: Toru
authors.initials: T
authors.lastname: Motokura
authors.forename: Akira
authors.initials: A
authors.lastname: Hangaishi
authors.forename: Junji
authors.initials: J
authors.lastname: Shibahara
authors.forename: Masaaki
authors.initials: M
authors.lastname: Akahane
authors.forename: Jun
authors.initials: J
authors.lastname: Goto
authors.forename: Shin
authors.initials: S
authors.lastname: Kwak
authors.forename: Mineo
authors.initials: M
authors.lastname: Kurokawa
authors.forename: Shoji
authors.initials: S
authors.lastname: Tsuji
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D058846:Antibodies, Monoclonal, Murine-Derived; D001921:Brain / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D002490:Central Nervous System / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D020031:Epstein-Barr Virus Infections / Q000150:complications; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage; D008168:Lung / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D008214:Lymphocytes / Q000276:immunology / Q000473:pathology / Q000821:virology; D008230:Lymphomatoid Granulomatosis / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020336:Paraparesis, Spastic / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D012074:Remission Induction; D000069283:Rituximab; D013116:Spinal Cord / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab