Rheumatoid Arthritis/Methotrexate-associated Primary Cutaneous Diffuse Large B-cell Lymphoma, Leg Type

Yosuke Matsumoto; Shigeo Horiike; Saori Maekawa; Taro Isohisa; Natsumi Sakamoto; Yoshiaki Chinen; Ryuko Nakayama; Miki Kiyota; Hisao Nagoshi; Shinsuke Mizutani; Yuji Shimura; Mio Sugitani; Tsutomu Kobayashi; Noriaki Nakai; Junya Kuroda; Masafumi Taniwaki

doi:10.2169/internalmedicine.53.1735

CASE REPORTS

Rheumatoid Arthritis/Methotrexate-associated Primary Cutaneous Diffuse Large B-cell Lymphoma, Leg Type

Yosuke Matsumoto, Shigeo Horiike, Saori Maekawa, Taro Isohisa, Natsumi Sakamoto, Yoshiaki Chinen, Ryuko Nakayama, Miki Kiyota, Hisao Nagoshi, Shinsuke Mizutani, Yuji Shimura, Mio Sugitani, Tsutomu Kobayashi, Noriaki Nakai, Junya Kuroda, Masafumi Taniwaki

Author information

Yosuke Matsumoto
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Shigeo Horiike
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Saori Maekawa
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Taro Isohisa
Department of Dermatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Natsumi Sakamoto
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Yoshiaki Chinen
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Ryuko Nakayama
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Miki Kiyota
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Hisao Nagoshi
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Shinsuke Mizutani
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Yuji Shimura
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Mio Sugitani
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Tsutomu Kobayashi
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Noriaki Nakai
Department of Dermatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Junya Kuroda
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan
Masafumi Taniwaki
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi Hirokoji, Japan

Keywords: primary cutaneous diffuse large B-cell lymphoma, leg type, rheumatoid arthritis, methotrexate

JOURNAL OPEN ACCESS

2014 Volume 53 Issue 11 Pages 1177-1181

DOI https://doi.org/10.2169/internalmedicine.53.1735

Details

Abstract

This report concerns a 62-year-old man with primary cutaneous diffuse large B-cell lymphoma (PCLBCL), leg type that developed during methotrexate (MTX) treatment for rheumatoid arthritis (RA). Several tumors were observed on the left lower leg. A histological analysis showed diffuse proliferation of large neoplastic B-cells that were immunophenotypically CD10-/MUM1+/BCL6-/BCL2+ and cytogenetically had IgH/c-MYC translocation without translocation involving BCL6 or IgH/BCL2. No evidence of Epstein-Barr virus (EBV) infection was found. The discontinuation of MTX resulted in a 20-month disease-free period. No previous cases of PCLBCL, leg type associated with RA or MTX therapy have been reported. The phenotypes of our patient were partly different from those of typical PCLBCL, leg type or RA/MTX-associated lymphoma.

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