口腔病変から診断に至った口腔・皮膚領域の異時性メトトレキサート関連リンパ増殖性疾患の1例

  • 村上 寿理
    鹿児島大学大学院医歯学総合研究科先進治療科学専攻顎顔面機能再建学講座口腔顎顔面外科学分野
  • 石畑 清秀
    鹿児島大学大学院医歯学総合研究科先進治療科学専攻顎顔面機能再建学講座口腔顎顔面外科学分野
  • 野添 悦郎
    鹿児島大学大学院医歯学総合研究科先進治療科学専攻顎顔面機能再建学講座口腔顎顔面外科学分野
  • 松本 幸三
    県立宮崎病院歯科口腔外科
  • 嶋 香織
    鹿児島大学大学院医歯学総合研究科先進治療科学専攻腫瘍学講座口腔病理解析学分野
  • 中村 典史
    鹿児島大学大学院医歯学総合研究科先進治療科学専攻顎顔面機能再建学講座口腔顎顔面外科学分野

書誌事項

タイトル別名
  • A case of methotrexate-associated lymphoproliferative disorder associated with oral and skin asynchronous ulcers diagnosed by an oral lesion
  • コウコウ ビョウヘン カラ シンダン ニ イタッタ コウコウ ・ ヒフ リョウイキ ノ イジセイ 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

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説明

<p>Methotrexate (MTX) has been recognized as a first-line treatment for rheumatoid arthritis (RA) because of its ability to reduce the proliferation of innate immune cells. Recently, the occurrence of methotrexate-associated lymphoproliferative disorders (MTX-LPD) in the oral cavity has been reported. We describe a case of MTX-LPD associated with asynchronous ulcers in the oral and skin regions that was diagnosed by oral lesions. A 79-year-old man had been receiving MTX for over 7 years as a treatment for RA. Two years earlier, a skin ulcer had developed in the lumbar region, which histopathologically diagnosed as a sarcoma, and he was treated with heavy-ion radiotherapy. Before he presented to our institution, he had severe bilateral gingival pain in the mandibular molar region for 2 months. The oral lesions appeared to be necrotic ulcers, and a pathological examination revealed lymphocytic infiltration involving atypical cells. Based on the patient's medical history and the results of a histopathological reexamination of the skin lesions, both the oral and skin lesions were diagnosed as MTX-LPD. Although the gingival lesions expanded over the next few weeks, the ulcers spontaneously disappeared after MTX treatment was withdrawn. There have been no signs of recurrence for 2 years.</p>

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