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基于磁共振波谱和寡克隆带预测中枢神经系统甲氨蝶呤相关性淋巴增殖性疾病的预后。

Prognosis Prediction Using Magnetic Resonance Spectroscopy and Oligoclonal Bands in Central Nervous System Methotrexate-associated Lymphoproliferative Disorder.

机构信息

Department of Neurology, Hiroshima City Hiroshima Citizens Hospital, Japan.

Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.

出版信息

Intern Med. 2022 Dec 15;61(24):3733-3738. doi: 10.2169/internalmedicine.9296-21. Epub 2022 May 21.

DOI:10.2169/internalmedicine.9296-21
PMID:35598995
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9841117/
Abstract

Central nervous system methotrexate-associated lymphoproliferative disorder (CNS-MTX-LPD) is rare, but its spontaneous regression has been observed in some patients after withdrawal of agents. We herein report three cases of primary CNS-MTX-LPD that received oral MTX for rheumatoid arthritis. Epstein-Barr virus and oligoclonal bands (OCBs) were positive, while proton magnetic resonance spectroscopy (H-MRS) showed an elevated lipid peak and slightly elevated choline/N-acetylaspartate ratio in common. After MTX withdrawal, brain lesions showed spontaneous regression in all cases. Our patient's H-MRS findings and OCBs may reflect a non-monoclonal lymphoproliferative histology as benign-type lesions in CNS-MTX-LPD.

摘要

中枢神经系统甲氨蝶呤相关性淋巴组织增生性疾病（CNS-MTX-LPD）较为罕见，但在一些患者停用药物后可自发消退。本文报告了 3 例接受甲氨蝶呤治疗类风湿关节炎的原发性 CNS-MTX-LPD 患者。这些患者的 EBV 和寡克隆区带（OCBs）均为阳性，质子磁共振波谱（H-MRS）显示共同的脂质峰升高和胆碱/N-乙酰天冬氨酸比值略有升高。停用 MTX 后，所有患者的脑部病变均自发消退。我们患者的 H-MRS 发现和 OCBs 可能反映了中枢神经系统 MTX-LPD 中非单克隆性淋巴组织增生的组织学，为良性病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b81/9841117/201d7430fa84/1349-7235-61-3733-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b81/9841117/162d10f29c88/1349-7235-61-3733-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b81/9841117/17363a20c2a0/1349-7235-61-3733-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b81/9841117/201d7430fa84/1349-7235-61-3733-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b81/9841117/162d10f29c88/1349-7235-61-3733-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b81/9841117/17363a20c2a0/1349-7235-61-3733-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b81/9841117/201d7430fa84/1349-7235-61-3733-g003.jpg

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