Composite Cutaneous Lymphoma (Iatrogenic Immunodeficiency-Associated Lymphoproliferative Disorder) in a Patient with Rheumatoid Arthritis Treated with Methotrexate: Staging and Evaluation of Response to Therapy with 18F-FDG PET/CT

A 67 year old woman with a 10 year history of rheumatoid arthritis (RA) treated with methotrexate and prednisone, presented with a 2 year history of worsening multiple cutaneous plaques of variable appearance. Two distinct skin lesions were biopsied to reveal a composite cutaneous lymphoma, possibly...

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Bibliographic Details
Published in:Nuclear medicine and molecular imaging 2017, 51(3), , pp.261-265
Main Authors: Makis, William, Ciarallo, Anthony, Wang, Beatrice, Gonzalez-Verdecia, Milene, Probst, Stephan
Format: Article
Language:English
Subjects:
Arthritis
Cardiology
Case Report
Chemotherapy
Computed tomography
Iatrogenesis
Imaging
Lesions
Lymphoma
Medicine
Medicine & Public Health
Methotrexate
Nuclear Medicine
Oncology
Orthopedics
Positron emission
Radiology
Rheumatoid arthritis
Skin
Tomography
방사선과학
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Summary:A 67 year old woman with a 10 year history of rheumatoid arthritis (RA) treated with methotrexate and prednisone, presented with a 2 year history of worsening multiple cutaneous plaques of variable appearance. Two distinct skin lesions were biopsied to reveal a composite cutaneous lymphoma, possibly caused by long term methotrexate therapy. An [18F] fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) was performed to stage the malignancy, and was later repeated to evaluate response to chemotherapy, which guided subsequent management. We present the PET/CT imaging findings of this very rare iatrogenic (methotrexate induced) immunodeficiency-associated lymphoproliferative disorder.
ISSN:1869-3474
1869-3482
DOI:10.1007/s13139-016-0463-4