title: [Methotrexate-related lymphomatoid granulomatosis successfully treated with discontinuation of methotrexate and radiotherapy to brain].
abstract: A 70-year-old woman with rheumatoid arthritis treated with methotrexate (MTX) complained of right arm weakness. On CT and MRI, tumors were found in the right frontal lobe, bilateral lungs, and left renal parenchyma. She was diagnosed as having lymphomatoid granulomatosis (LYG) grade 2 on thoracoscopic biopsy of the left lung. We discontinued MTX and treated a mass lesion in the right frontal lobe with stereotactic radiotherapy. As a result, the tumors showed a gradual reduction in size, and the patient achieved complete remission. LYG is a rare lymphoproliferative disorder, and has various clinical characteristics. We describe herein a patient with LYG grade 2 with cerebral, pulmonary, and renal lesions, who has maintained a complete remission for six months, to date, after treatment.
authors.affiliation: Department of Hematology, Hokkaido Cancer Center.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yamakawa
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Kurosawa
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Yonezumi
authors.forename: Sachiko
authors.initials: S
authors.lastname: Suzuki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000532:radiotherapy* / Q000821:virology; D005260:Female; D005625:Frontal Lobe; D004854:Herpesvirus 4, Human / Q000502:physiology; D006801:Humans; D016867:Immunocompromised Host; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000821:virology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000821:virology; D008230:Lymphomatoid Granulomatosis / Q000175:diagnosis / Q000209:etiology* / Q000532:radiotherapy* / Q000821:virology; D008279:Magnetic Resonance Imaging; D008727:Methotrexate / Q000009:adverse effects*; D012074:Remission Induction; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014775:Virus Activation
chemical_list: D018501:Antirheumatic Agents; D008727:Methotrexate