• Internal medicine · Jan 2022

    Case Reports

    Development of Intravascular Large B-cell Lymphoma during Methotrexate Treatment for Rheumatoid Arthritis.

    • Tomohisa Tabuchi, Hirosaka Inoue, and Kosuke Obama.
    • Department of Hematology, Imakiire General Hospital, Japan.
    • Intern. Med. 2022 Jan 1; 61 (1): 87-90.

    AbstractA 56-year-old woman with rheumatoid arthritis who had been taking methotrexate (MTX) for six years visited our hospital with dyspnea and dizziness. Abdominal ultrasonography revealed mild splenomegaly. Laboratory examinations showed a marked elevation in soluble interleukin-2 receptor and lactate dehydrogenase levels. These abnormalities revealed a spontaneous regression after MTX discontinuation, however, they worsened again four months later. Skin biopsies revealed a diagnosis of intravascular large B-cell lymphoma (IVLBCL), and we diagnosed MTX-associated IVLBCL (MTX-IVLBCL) based on its characteristic course. Despite the recurrence of IVLBCL, it showed a good response to chemotherapy. MTX-IVLBCL should therefore be treated with consideration since it has different characteristics from that of de novo IVLBCL.

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