Methotrexate-associated lymphoproliferative disease detected as a colorectal mass lesions: a case report

Author:

Shirakabe Katsudai1ORCID,Mizokami Ken1

Affiliation:

1. Department of General Surgery, Tokyo Bay Urayasu Ichikawa Medical Center , Urayasu, Chiba , Japan

Abstract

AbstractMethotrexate-related lymphoproliferative disorder (MTX-LPD) is a rare but serious complication that occurs in patients treated with methotrexate (MTX); although MTX-LPD has been reported recently, the incidence in the colon is very low. A 79-year-old woman who had been receiving MTX for 15 years came to our hospital complaining of postprandial abdominal pain and nausea. Computed tomography scan showed the dilation of the small bowel and a tumor in the cecum. In addition, numerous nodular lesions were seen in the peritoneum. Ileal-transverse colon bypass surgery was performed for small bowel obstruction. Histopathological findings of both the cecum and the peritoneal nodules revealed the diagnosis of MTX-LPD. We report MTX-LPD occurring in the colon; it is important to consider MTX-LPD when intestinal symptoms occur during MTX therapy.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference8 articles.

1. Lymphoma developing in a patient with rheumatoid arthritis taking low dose weekly methotrexate;Ellman;J Rheumatol,1991

2. Lymphoproliferative disorders in rheumatoid arthritis: clinicopathological analysis of 76 cases in relation to methotrexate medication;Hoshida;J Rheumatol,2007

3. Methotrexate-associated lymphoproliferative disorder;Kaneko;Nihon Rinsho Meneki Gakkai Kaishi,2017

4. Association of higher methotrexate dose with lymphoproliferative disease onset in rheumatoid arthritis patients;Kameda;Arthritis Care Res,2014

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