Four Cases of Other Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorders in the Head and Neck Region

Fukasawa, Masahiko; Akazawa, Yoshihiro; Kasugai, Shigeru; Mikami, Koshi; Saito, Yoshimitsu; Akutsu, Masatoshi; Akashi, Aibi; Ido, Kojiro; Maeda, Ichiro; Hoshikawa, Masahiro; Koizuka, Izumi

doi:10.3950/jibiinkoka.119.741

Cited by 5 publications

(1 citation statement)

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“…The present patient developed LPD during treatment with MTX and TAC. Although a case series reported the onset of LPD during TAC use in RA patients (6), an observational study in Japan indicated that MTX and TAC were independent risk factors for LPD (7). Accordingly, we speculate that both MTX and TAC may have contributed to the development of LPD in our patient.…”

Section: Discussionmentioning

confidence: 99%

Gastric Perforation due to Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder during the Treatment of Rheumatoid Arthritis

et al. 2019

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A 71-year-old woman being treated with methotrexate (MTX) and tacrolimus (TAC) for rheumatoid arthritis (RA) was admitted to our hospital and underwent surgery for gastric perforation and peritonitis. An endoscopic examination six days post-surgery showed an extensive ulcer in the stomach, and a biopsy revealed diffused large B-cell lymphoma. We diagnosed her with immunodeficiency-associated lymphoproliferative disorder (LPD) and discontinued the MTX and TAC. She underwent gastrectomy due to stenosis approximately two months after the first operation, but the histopathological findings of lymphoma had disappeared. LPD should be considered as a potential cause of gastric perforation during RA treatment.

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Section: Discussionmentioning

confidence: 99%

Gastric Perforation due to Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder during the Treatment of Rheumatoid Arthritis

et al. 2019

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EBV-positive PEL-like lymphoma that developed in the course of antisynthetase syndrome treated with tacrolimus

et al. 2018

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Primary effusion lymphoma (PEL) is a rare type of extranodal lymphoma, typically of a B-cell origin, which presents as lymphomatous effusion with no nodal enlargement or tumor masses. The development PEL is universally associated with human herpes virus-8 (HHV-8) infection. Cases of HHV-8-negative primary lymphomatous effusion have recently been reported and referred to as HHV-8-unrelated PEL-like lymphoma. Some cases of this disease have been reported in iatrogenic immunocompromised patients. The mechanisms responsible for the inhibitory effects of the discontinuation of immunosuppressants other than methotrexate (MTX) against the disease, which have been demonstrated for MTX-associated lymphoproliferative disorders, have not yet been elucidated. We describe a case of PEL-like lymphoma that developed in the course of antisynthetase syndrome and was treated with tacrolimus. A single dose of systemic chemotherapy did not improve lymphomatous effusion, whereas the discontinuation of tacrolimus resulted in the long-term remission of this disease.

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Methotrexate/tacrolimus

2016

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Four Cases of Other Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorders in the Head and Neck Region

Cited by 5 publications

References 5 publications

Gastric Perforation due to Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder during the Treatment of Rheumatoid Arthritis

Gastric Perforation due to Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder during the Treatment of Rheumatoid Arthritis

EBV-positive PEL-like lymphoma that developed in the course of antisynthetase syndrome treated with tacrolimus

Methotrexate/tacrolimus

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