成人期若年性特発性関節炎患者の上顎に発生したメトトレキサート関連リンパ増殖性疾患の1例

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  • A case of methotrexate-associated lymphoproliferative disorders arising in the maxilla in a patient with juvenile idiopathic arthritis in adulthood
  • セイジンキ ジャクネンセイ トクハツセイ カンセツエン カンジャ ノ ウワアゴ ニ ハッセイ シタ 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 methotrexate-associated lymphoproliferative disorders in the maxilla in a patient with juvenile idiopathic arthritis in adulthood

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Methotrexate (MTX) is a key drug widely used to treat rheumatoid arthritis. However, several reports have recently described cases of MTX-associated lymphoproliferative disorders (MTX-LPD). We report a case of MTX-LPD arising in the maxilla of a patient with juvenile idiopathic arthritis in adulthood.<br>A 40-year-old woman was referred to our clinic for the treatment of pain in the anterior maxillary gingiva. She had had juvenile idiopathic arthritis in adulthood and had received MTX for 4 years. On clinical examination, a swelling was noted at the incisal region of the maxilla. CT imaging showed a diffuse bone defect around the roots of the maxillary incisors. Antibiotic therapy had no effect on the lesion, and a biopsy was carried out. The histopathological diagnosis was diffuse large B cell lymphoma. After discussion with her physician, we suspected MTX-LPD and directed her to stop taking MTX. After stopping MTX, the lesion disappeared.

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