Hemophagocytic Syndrome-Associated Variant of Methotrexate-Associated Intravascular Large B-Cell Lymphoma in a Rheumatoid Arthritis Patient
Joint Authors
Komeno, Yukiko
Abe, Keiko
Iihara, Kuniko
Ryu, Tomiko
Akiyama, Minako
Okochi, Yasumi
Tokuda, Hitoshi
Source
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-09-11
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
A 59-year-old man was treated for rheumatoid arthritis (RA) for 12 years with methotrexate (MTX) and prednisolone.
After MTX-associated interstitial pneumonia developed, he was treated with cyclophosphamide and prednisolone for 7 months.
Arthritis worsened, and tacrolimus was added to the treatment regimen.
One month later, he had fever, loss of appetite, and dyspnea on exertion.
Blood tests showed pancytopenia with large, atypical lymphocytes.
Computed tomography showed mild splenomegaly.
Bone marrow examination demonstrated CD20-positive, EBER-positive atypical lymphocytes, and hemophagocytosis.
Random skin biopsy led to the diagnosis of intravascular large B-cell lymphoma (IVLBCL).
The final diagnosis was a hemophagocytic syndrome-associated variant of IVLBCL.
Complete remission was achieved after seven courses of R-CHOP.
However, within a month, he complained of dizziness.
Magnetic resonance imaging revealed focal infarctions in the cerebellum and around the left lateral ventricle.
Central nervous system relapse was suspected.
Although salvage chemotherapy (CHASER), whole brain irradiation, and intrathecal injection of cytarabine and prednisolone were temporarily effective, he died.
Autopsy revealed infiltration of lymphoma cells in the brain and adrenal glands.
To the best of our knowledge, this is the sixth case of IVLBCL and the first case of the hemophagocytic syndrome-associated variant of IVLBCL in RA patients in the literature.
American Psychological Association (APA)
Komeno, Yukiko& Akiyama, Minako& Okochi, Yasumi& Tokuda, Hitoshi& Abe, Keiko& Iihara, Kuniko…[et al.]. 2019. Hemophagocytic Syndrome-Associated Variant of Methotrexate-Associated Intravascular Large B-Cell Lymphoma in a Rheumatoid Arthritis Patient. Case Reports in Hematology،Vol. 2019, no. 2019, pp.1-6.
https://search.emarefa.net/detail/BIM-1136727
Modern Language Association (MLA)
Komeno, Yukiko…[et al.]. Hemophagocytic Syndrome-Associated Variant of Methotrexate-Associated Intravascular Large B-Cell Lymphoma in a Rheumatoid Arthritis Patient. Case Reports in Hematology No. 2019 (2019), pp.1-6.
https://search.emarefa.net/detail/BIM-1136727
American Medical Association (AMA)
Komeno, Yukiko& Akiyama, Minako& Okochi, Yasumi& Tokuda, Hitoshi& Abe, Keiko& Iihara, Kuniko…[et al.]. Hemophagocytic Syndrome-Associated Variant of Methotrexate-Associated Intravascular Large B-Cell Lymphoma in a Rheumatoid Arthritis Patient. Case Reports in Hematology. 2019. Vol. 2019, no. 2019, pp.1-6.
https://search.emarefa.net/detail/BIM-1136727
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1136727