• Internal medicine · Jul 2023

    Case Reports

    Rituximab Monotherapy for Grade 2-3 Lymphomatoid Granulomatosis with Central Nervous System Involvement in a Patient Receiving Methotrexate for Rheumatoid Arthritis.

    • Hiroki Hosoi, Ken Tanaka, Ayaka Sakaki, Hideki Kosako, Ryuta Iwamoto, Ai Matsumoto, Fumiko Arakawa, Toshikazu Yamoto, Shogo Murata, Toshiki Mushino, Shin-Ichi Murata, Naoyuki Nakao, Koichi Ohshima, and Takashi Sonoki.
    • Department of Hematology/Oncology, Wakayama Medical University, Japan.
    • Intern. Med. 2023 Jul 1; 62 (13): 197719821977-1982.

    AbstractLymphomatoid granulomatosis (LYG) is a rare lymphoproliferative disorder (LPD). The optimal management strategy of methotrexate (MTX) related-LPD with central nervous system (CNS) involvement and histological features of LYG remains unclear. We herein report a case of grade 2-3 LYG in a rheumatoid arthritis patient, in which an intracranial mass accompanied by hemorrhaging and pulmonary and skin lesions developed. The patient received successful rituximab monotherapy. The tumor cells in the skin and brain showed monoclonal and oligoclonal proliferation, respectively. Our case suggests that rituximab monotherapy may be effective against MTX-LPD with CNS involvement, especially in cases with LYG histology.

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