Reversible methotrexate associated lymphoproliferative disease evolving into Hodgkin's disease.
Reversible methotrexate associated lymphoproliferative disease evolving into Hodgkin's disease.
复制标题
可逆性甲氨蝶呤相关淋巴组织增生性疾病演变成霍奇金病。
作者：
A. Moseley;H. Lindsley;B. Skikne;O. Tawfik
我们描述了一例结节性硬化性霍奇金病（NSHD）病例，该病例是一名患有血清阳性类风湿性关节炎的61岁女性，接受口服甲氨蝶呤（MTX）5至15 mg/周治疗5年。腹部计算机断层扫描（CT）显示脾肿大和明显的腹部和腹膜后淋巴结肿大。MTX停药;几周后，加用泼尼松10 mg/天，以控制多关节痛恶化。3个月时重复CT显示脾肿大和淋巴结病几乎完全消退。然而，10个月时的CT研究显示淋巴结病无症状进展，活检显示NSHD。具有明显可逆的MTX相关淋巴增生性疾病的患者需要定期监测恶性淋巴瘤的无症状发展。
We describe a case of nodular sclerosing Hodgkin's disease (NSHD) developing in a 61-year-old woman with seropositive rheumatoid arthritis treated with oral methotrexate (MTX) 5 to 15 mg/week for 5 years. Computed tomography (CT) of the abdomen revealed splenomegaly and marked abdominal and retroperitoneal lymphadenopathy. MTX was discontinued; several weeks later prednisone 10 mg/day was added to control worsening polyarthralgia. Repeat CT at 3 months showed almost complete regression of the splenomegaly and lymphadenopathy. However, CT studies at 10 months showed asymptomatic progression of lymphadenopathy, which on biopsy revealed NSHD. Patients with apparently reversible MTX associated lymphoproliferative disorder require periodic monitoring for asymptomatic development of malignant lymphoma.