Display options
Cite
Takei D, Abe T, Amano H, et al. Methotrexate-associated primary hepatic malignant lymphoma following hepatectomy: A case report. Int J Surg Case Rep. 2016;31:5-9doi: 10.1016/j.ijscr.2016.12.012.
Takei, D., Abe, T., Amano, H., Hirano, N., Kobayashi, T., Ohdan, H., Kondo, T., Nakahara, M., & Noriyuki, T. (2017). Methotrexate-associated primary hepatic malignant lymphoma following hepatectomy: A case report. International journal of surgery case reports, 315-9. https://doi.org/10.1016/j.ijscr.2016.12.012
Takei, Daisuke, et al. "Methotrexate-associated primary hepatic malignant lymphoma following hepatectomy: A case report." International journal of surgery case reports vol. 31 (2017): 5-9. doi: https://doi.org/10.1016/j.ijscr.2016.12.012
Takei D, Abe T, Amano H, Hirano N, Kobayashi T, Ohdan H, Kondo T, Nakahara M, Noriyuki T. Methotrexate-associated primary hepatic malignant lymphoma following hepatectomy: A case report. Int J Surg Case Rep. 2017;31:5-9. doi: 10.1016/j.ijscr.2016.12.012. Epub 2016 Dec 21. PMID: 28076752; PMCID: PMC5222945.
Copy Download .nbib Format: NLM
Share it on

Int J Surg Case Rep. 2017;31:5-9. doi: 10.1016/j.ijscr.2016.12.012. Epub 2016 Dec 21.

Methotrexate-associated primary hepatic malignant lymphoma following hepatectomy: A case report.

International journal of surgery case reports

Daisuke Takei, Tomoyuki Abe, Hironobu Amano, Naomichi Hirano, Tsuyoshi Kobayashi, Hideki Ohdan, Toshinori Kondo, Masahiro Nakahara, Toshio Noriyuki

Affiliations

  1. Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
  2. Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan. Electronic address: [email protected].
  3. Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Japan.
  4. Department of Gastroenterology,Onomichi General Hospital, Onomichi, Hiroshima, Japan.
  5. Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Japan.
  6. Kawasaki Medical School Hospital, Kurashiki, Okayama, Japan.

PMID: 28076752 PMCID: PMC5222945 DOI: 10.1016/j.ijscr.2016.12.012

Abstract

INTRODUCTION: Recently, immunosuppressant-associated malignant lymphoma (ML) cases have been increasing along with the development of several effective immunosuppressant drugs for rheumatoid arthritis (RA). Among methotrexate (MTX)-associated lymphoproliferative disorders, primary hepatic lymphoma (PHL) in patients with RA following surgical resection has not been reported previously.

PRESENTATION OF CASE: A 65-year-old woman who is a hepatitis B virus carrier with a history of RA was admitted. MTX was introduced seven years prior as an RA treatment. Her laboratory data showed no elevation of several tumor markers, and liver function test results were normal. On contrasted computed tomography (CT) scanning, a slightly enhanced tumor was detected at the early phase, and tumor staining was sustained at the delayed phase. Further, subsegmentectomy of the S6 was performed. The pathological diagnosis was diffuse large B-cell lymphoma. However, positron emission tomography-CT and bone marrow aspiration sample showed no resident sign of ML.

DISCUSSION: Diagnosis of PHL before surgery is difficult. If the mass lesion was solitary and had a certain degree of size, then resection could be performed for its treatment and diagnosis. The treatment for ML requires a diagnosis of the subtypes to select a therapeutic agent and determine the prognosis. Once a precise preoperative diagnosis was made, withdrawing MTX could be the first treatment in case of MTX-related ML.

CONCLUSION: Long-term usage of immunosuppressant drugs could cause proliferative ML. Considering the increasing occurrence of MTX-related ML, withdrawing MTX should be considered, especially in patients with long-term immunosuppressant usage for RA.

Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Keywords: Diffuse large B cell lymphoma; Methotrexate; Primary hepatic malignant lymphoma

References

  1. Biomark Res. 2015 May 06;3:10 - PubMed
  2. Clin Radiol. 2001 Apr;56(4):295-301 - PubMed
  3. Am J Clin Pathol. 2000 Feb;113(2):212-8 - PubMed
  4. Case Rep Hematol. 2014;2014:460574 - PubMed
  5. J Natl Cancer Inst. 2004 Nov 17;96(22):1691-702 - PubMed
  6. Cancer. 2001 Oct 15;92(8):2023-9 - PubMed
  7. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Oct;118(4):e105-10 - PubMed
  8. J Rheumatol. 1991 Nov;18(11):1741-3 - PubMed
  9. N Engl J Med. 1993 May 6;328(18):1317-21 - PubMed
  10. Rev Rhum Engl Ed. 1998 Apr;65(4):267-73 - PubMed
  11. Crit Rev Oncol Hematol. 2005 Mar;53(3):199-207 - PubMed
  12. J Gastrointest Cancer. 2014 Sep;45(3):380-2 - PubMed
  13. J Clin Oncol. 1996 Jun;14(6):1943-9 - PubMed
  14. Curr Opin Rheumatol. 2004 May;16(3):254-61 - PubMed
  15. Cancer Sci. 2010 May;101(5):1309-13 - PubMed
  16. Intern Med. 2015 ;54(4):401-5 - PubMed
  17. Radiology. 1994 Apr;191(1):135-6 - PubMed
  18. AJR Am J Roentgenol. 2008 Jul;191(1):198-206 - PubMed

Publication Types