Prognosis Prediction Using Magnetic Resonance Spectroscopy and Oligoclonal Bands in Central Nervous System Methotrexate-associated Lymphoproliferative Disorder |
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| Authors: | Hiroki Ueno Narumi Ohno Takafumi Abe Kazuki Kimoto Chika Matsuoka Mayumi Giga Hiroyuki Naito Tomoyuki Kono Miyuki Takasu Naoya Kidani Rie Yamasaki Koichi Ichimura Eiichi Nomura |
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| Affiliation: | 1.Department of Neurology, Hiroshima City Hiroshima Citizens Hospital, Japan; 2.Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan; 3.Department of Radiology, Hiroshima City Hiroshima Citizens Hospital, Japan; 4.Department of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens Hospital, Japan; 5.Department of Pathology, Hiroshima City Hiroshima Citizens Hospital, Japan |
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| Abstract: | Central nervous system methotrexate-associated lymphoproliferative disorder (CNS-MTX-LPD) is rare, but its spontaneous regression has been observed in some patients after withdrawal of agents. We herein report three cases of primary CNS-MTX-LPD that received oral MTX for rheumatoid arthritis. Epstein-Barr virus and oligoclonal bands (OCBs) were positive, while proton magnetic resonance spectroscopy (1H-MRS) showed an elevated lipid peak and slightly elevated choline/N-acetylaspartate ratio in common. After MTX withdrawal, brain lesions showed spontaneous regression in all cases. Our patient''s 1H-MRS findings and OCBs may reflect a non-monoclonal lymphoproliferative histology as benign-type lesions in CNS-MTX-LPD. |
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| Keywords: | methotrexate-associated lymphoproliferative disorder EBV MRS oligoclonal bands |
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