Primary Cerebral Lymphomatoid Granulomatosis Progressing to Methotrexate-associated Lymphoproliferative Disease Under Immunosuppressive Therapy

Hiroaki Tanaka; Shogo Furukawa; Yusuke Takeda; Naomi Shimizu; Takeharu Kawaguchi; Chika Kawajiri; Shinichiro Hashimoto; Toshiyuki Takagi; Shoichi Ito; Satoshi Ota; Satoshi Kuwabara; Chiaki Nakaseko

doi:10.2169/internalmedicine.54.2399

CASE REPORTS

Primary Cerebral Lymphomatoid Granulomatosis Progressing to Methotrexate-associated Lymphoproliferative Disease Under Immunosuppressive Therapy

Hiroaki Tanaka, Shogo Furukawa, Yusuke Takeda, Naomi Shimizu, Takeharu Kawaguchi, Chika Kawajiri, Shinichiro Hashimoto, Toshiyuki Takagi, Shoichi Ito, Satoshi Ota, Satoshi Kuwabara, Chiaki Nakaseko

Author information

Hiroaki Tanaka
Department of Hematology, Oami Municipal Hospital, Japan
Shogo Furukawa
Department of Neurology, Chiba University Hospital, Japan
Yusuke Takeda
Department of Hematology, Chiba University Hospital, Japan
Naomi Shimizu
Department of Hematology, Chiba University Hospital, Japan
Takeharu Kawaguchi
Department of Hematology, Oami Municipal Hospital, Japan
Chika Kawajiri
Department of Hematology, Chiba University Hospital, Japan
Shinichiro Hashimoto
Department of Hematology, Oami Municipal Hospital, Japan
Toshiyuki Takagi
Department of Hematology, Oami Municipal Hospital, Japan
Shoichi Ito
Department of Neurology, Chiba University Hospital, Japan
Satoshi Ota
Department of Pathology, Chiba University Hospital, Japan
Satoshi Kuwabara
Department of Neurology, Chiba University Hospital, Japan
Chiaki Nakaseko
Department of Hematology, Chiba University Hospital, Japan

Keywords: primary cerebral lymphomatoid granulomatosis, methotrexate-associated lymphoproliferative disease, Epstein-Barr virus, methotrexate, rituximab

JOURNAL OPEN ACCESS

2015 Volume 54 Issue 5 Pages 503-507

DOI https://doi.org/10.2169/internalmedicine.54.2399

Details

Abstract

Lymphomatoid granulomatosis (LYG) is an angiocentric and angiodestructive lymphoproliferative disease involving extranodal sites. Although LYG cerebral lesions are usually located adjacent to LYG pulmonary lesions, few reports have described the occurrence of primary cerebral LYG. We herein discuss a case of a 40-year-old Japanese woman with primary cerebral LYG that caused various neurological symptoms for more than five years and progressed to methotrexate-associated lymphoproliferative disease under treatment with immunosuppressive therapy. This case suggests that primary cerebral LYG should be considered a lymphoid neoplasm manifesting as a primary brain tumor and a component of the differential diagnosis of chronic neuroinflammatory disorders.

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