Primary central nervus system lymphoma developing methotrexate pneumonitis due to high-dose treatment

Abstract

A 58-year-old man admitted for gaitdisturbance and dysarthria was fbund in postcontrast MRI of the brain to have a hyperintense mass in the splenium of the corpus callosum and around bilateral deep white matter. Ile was referred to the department of neurosurgery in July 2002. Brain tumor biopsy showed diff'use large B cell lymphoma, and he was diagnosed with primary central nervous system lymphoma. After a ndergoing two courses of high-dose methotrexate chemtotherapy, he developed drug-induced pneumonitis with high lever, shortness of breath, and fine crackles, confirmed by drug lymphocyte stimulation tests. Alter steroid pulse therapy, his pneumonitis markedly improved. Therefore, it is important that patients receiving rnethotrexate be carefully watched for adverse pulmonary effects.