Polymorphic lymphoproliferative disorder arising in a rheumatoid arthritis patient, presenting as fibrin-associated large B-cell lymphoma-like lesions in aortic and mitral valves.

IF 2.5 4区 医学 Q2 PATHOLOGY
Pathology International Pub Date : 2024-05-01 Epub Date: 2024-04-02 DOI:10.1111/pin.13424
Hideaki Tsujii, Ryuko Nakayama, Sohei Funakoshi, Shuhei Tsuji, Hironori Haga, Kazuo Ono
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引用次数: 0

Abstract

We herein report a case of methotrexate-associated lymphoproliferative disorder (MTX-LPD) showing fibrin-associated large B-cell lymphoma-like heart valve lesions, and Epstein-Barr virus (EBV)-positive mucocutaneous ulcer-like cutaneous and oral mucosal lesions. MTX-LPD is a critical complication that can occur in RA patients who are treated with MTX. EBV also plays a defining or important role in LPDs. Among the sites of MTX-LPD, 40-50% occur in extranodal sites, including the gastrointestinal tract, skin, liver, lung, and kidney. There are few reports of MTX-LPDs involving the heart valves, and to the best of our knowledge, this is the first case to be reported in the English literature. The possibility of EBV-positive LPD should be considered in RA patients, even in patients with an atypical site, as in this case.

一名类风湿性关节炎患者出现多形性淋巴组织增生性疾病,表现为主动脉瓣和二尖瓣的纤维蛋白相关大 B 细胞淋巴瘤样病变。
我们在此报告了一例甲氨蝶呤相关淋巴组织增生性疾病(MTX-LPD)病例,该病例表现为纤维蛋白相关大B细胞淋巴瘤样心脏瓣膜病变,以及爱泼斯坦-巴氏病毒(EBV)阳性的粘膜溃疡样皮肤和口腔粘膜病变。MTX-LPD是接受MTX治疗的RA患者可能出现的一种严重并发症。EB病毒在LPD中也起着决定性或重要的作用。在MTX-LPD的发病部位中,40%-50%发生在结外部位,包括胃肠道、皮肤、肝脏、肺部和肾脏。关于MTX-LPD累及心脏瓣膜的报道很少,据我们所知,这是英文文献中报道的第一例。在RA患者中应考虑EBV阳性LPD的可能性,即使是像本病例这样发病部位不典型的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pathology International
Pathology International 医学-病理学
CiteScore
4.50
自引率
4.50%
发文量
102
审稿时长
12 months
期刊介绍: Pathology International is the official English journal of the Japanese Society of Pathology, publishing articles of excellence in human and experimental pathology. The Journal focuses on the morphological study of the disease process and/or mechanisms. For human pathology, morphological investigation receives priority but manuscripts describing the result of any ancillary methods (cellular, chemical, immunological and molecular biological) that complement the morphology are accepted. Manuscript on experimental pathology that approach pathologenesis or mechanisms of disease processes are expected to report on the data obtained from models using cellular, biochemical, molecular biological, animal, immunological or other methods in conjunction with morphology. Manuscripts that report data on laboratory medicine (clinical pathology) without significant morphological contribution are not accepted.
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