Methotrexate-related Primary Hepatic Lymphoma in a Patient with Rheumatoid Arthritis

Koichiro Miyagawa; Michihiko Shibata; Hirotsugu Noguchi; Tsuguru Hayashi; Shinji Oe; Masaaki Hiura; Shintaro Abe; Masaru Harada

doi:10.2169/internalmedicine.54.3361

CASE REPORTS

Methotrexate-related Primary Hepatic Lymphoma in a Patient with Rheumatoid Arthritis

Koichiro Miyagawa, Michihiko Shibata, Hirotsugu Noguchi, Tsuguru Hayashi, Shinji Oe, Masaaki Hiura, Shintaro Abe, Masaru Harada

Author information

Koichiro Miyagawa
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Michihiko Shibata
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Hirotsugu Noguchi
Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, Japan
Tsuguru Hayashi
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Shinji Oe
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Masaaki Hiura
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Shintaro Abe
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
Masaru Harada
The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan

Keywords: primary hepatic lymphoma, methotrexate, malignant lymphoma, rheumatoid arthritis

JOURNAL OPEN ACCESS

2015 Volume 54 Issue 4 Pages 401-405

DOI https://doi.org/10.2169/internalmedicine.54.3361

Details

Abstract

A 56-year-old woman with rheumatoid arthritis treated with methotrexate (MTX) was admitted to our hospital due to multiple liver tumors. Contrast-enhanced computed tomography (CT) revealed multiple hypovascular masses, and 18F-fluorodeoxyglucose positron emission tomography CT showed diffuse abnormal accumulation in the liver only. We therefore made a diagnosis of MTX-related primary hepatic lymphoma (MTX-PHL) exhibiting features of diffuse large B-cell lymphoma. Although MTX has been reported to increase the risk of lymphoproliferative disorders, MTX-PHL has not been reported previously. The present case is the first case in which MTX appears to have been involved in the development of PHL.

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