老年类风湿关节炎患者甲氨蝶呤相关淋巴增生性疾病伴溶骨性脊柱病变：病例报告。
Methotrexate-associated lymphoproliferative disorder with an osteolytic vertebral lesion in an elderly patient with rheumatoid arthritis: A case report.
机构信息
Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tamba, Japan.
Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, Kobe, Japan.
出版信息
J Clin Pharm Ther. 2021 Aug;46(4):1178-1181. doi: 10.1111/jcpt.13415. Epub 2021 Mar 25.
WHAT IS KNOWN AND OBJECTIVE
Methotrexate-associated lymphoproliferative disorder (MTX-LPD) is a rare complication that develops in patients treated with methotrexate (MTX).
CASE SUMMARY
A 76-year-old male patient had been taking MTX for his rheumatoid arthritis. Computed tomography (CT) revealed masses in the liver, right adrenal gland and T6-T7 vertebra, including an osteolytic lesion. FDG-PET scan showed increased uptake in each lesion. MTX was discontinued, and CT showed complete remission of the tumours after three months. The disease course confirmed MTX-LPD diagnosis.
WHAT IS NEW AND CONCLUSION
Bone lesions in LPDs mimic those of metastatic cancer. MTX-LPD should be considered in patients on MTX presenting with mass lesions.
已知和目的
甲氨蝶呤相关性淋巴增生性疾病（MTX-LPD）是一种罕见的并发症，发生在接受甲氨蝶呤（MTX）治疗的患者中。
病例总结
一名 76 岁男性患者因类风湿性关节炎一直在服用 MTX。计算机断层扫描（CT）显示肝脏、右肾上腺和 T6-T7 椎体有肿块，包括溶骨性病变。FDG-PET 扫描显示每个病变部位摄取增加。停用 MTX 后，三个月后 CT 显示肿瘤完全缓解。疾病过程证实了 MTX-LPD 的诊断。
新内容和结论
LPD 中的骨病变类似于转移性癌症的病变。对于出现肿块病变的 MTX 患者，应考虑 MTX-LPD。
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