A case of intraoral methotrexate-assosiated lymphoproliferative disorder

DOI Web Site 11 Citations 28 References
  • HATANAKA Takashi
    Department of Oral and Maxillofacial Surgery, Nakatsugawa Municipal General Hospital
  • SAWAKI Yoshihiro
    Department of Oral and Maxillofacial Surgery, Nakatsugawa Municipal General Hospital
  • YAMADA Jun-ichi
    Department of Oral and Maxillofacial Surgery, Nakatsugawa Municipal General Hospital
  • FURUE Hiroki
    Department of Maxillofacial Surgery, Field of Head and Neck and Sensory Organ Medicine, Nagoya University, Postgraduate School of Medicine
  • FU Saisei
    Department of Oral and Maxillofacial Surgery, Fukuroi Municipal Hospital
  • UEDA Minoru
    Department of Maxillofacial Surgery, Field of Head and Neck and Sensory Organ Medicine, Nagoya University, Postgraduate School of Medicine

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Other Title
  • 口腔内メトトレキサート関連リンパ増殖性疾患の1例
  • コウクウ ナイ メトトレキサート カンレン リンパ ゾウショクセイ シッカン ノ 1レイ
  • A case of intraoral methotrexate-associated lymphoproliferative disorder

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Methotrexate （MTX） has been used not only for cancer and leukemia therapy, but also for the treatment of rheumatoid arthritis （RA）. However, some reports caution that MTX might induce MTX-associated limphoproliferative disorders （MTX-LPD）. We report a case of MTX-LPD associated with a gingival ulcer, which led to the diagnosis. A 66-year-old woman was referred to our hospital because of a chronic gingival nlcer of the maxilla. She had been receiving predonisolone （PSL） and MTX for over 12 years to treat RA. She had noticed an upper gingival ulcer 2 months before presentation, which gradually increased in size. Computed tomography showed bone resorption in the anterior region of the maxilla. Reported pathological examination revealed diffuse large B-cell lymphoma and immunohistochemistry supported the diagnosis of MTX-LPD. After stopping MTX,removing the necrotic bone, and antibacterial chemotherapy, the ulcer spontaneously resolved.

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