Magnetic resonance imaging of methotrexate-related lymphoproliferative disorder with a chief complaint of oral symptoms

Objectives To determine the magnetic resonance imaging (MRI) features of methotrexate-related lymphoproliferative disorder (MTX-LPD) in the oral cavity of a patient with a chief complaint of oral symptoms. Methods We included six patients who visited our hospital between November 2014 and November 2...

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Published in:Oral radiology 2023-04, Vol.39 (2), p.235-241
Main Authors: Kuribayashi, Ami, Kawashima, Sakurako, Kayamori, Kou, Sakamoto, Junichiro, Tomisato, Hiroshi, Watanabe, Hiroshi, Kurabayashi, Tohru
Format: Article
Language:English
Subjects:
Arthritis, Rheumatoid - pathology
Dentistry
Diffusion coefficient
Diffusion Magnetic Resonance Imaging
Humans
Imaging
Lymphatic diseases
Lymphocytes
Lymphoproliferative Disorders - chemically induced
Lymphoproliferative Disorders - diagnostic imaging
Magnetic Resonance Imaging
Medicine
Methotrexate
Methotrexate - adverse effects
Oral and Maxillofacial Surgery
Oral carcinoma
Oral cavity
Original Article
Radiology
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Summary:Objectives To determine the magnetic resonance imaging (MRI) features of methotrexate-related lymphoproliferative disorder (MTX-LPD) in the oral cavity of a patient with a chief complaint of oral symptoms. Methods We included six patients who visited our hospital between November 2014 and November 2019, histopathologically diagnosed with MTX-LPD. All images were examined using 3 T MRI and reviewed by two radiologists. Results Masses were detected in five cases; all masses demonstrated signal hypointensity and homogeneous signal hyperintensity on T1- and T2-weighted images with fat suppression. Homogeneous enhancement with fat suppression was evident on post-contrast T1-weighted imaging. We performed dynamic contrast-enhanced MRI in three cases and observed early enhancement with a low washout ratio pattern in all cases. Four patients underwent diffusion-weighted MRI and revealed low mean apparent diffusion coefficient (ADC) of 0.57 (range 0.5–0.65) × 10 –3 mm 2 /s. Conclusions We reported on the imaging characteristics of six rare cases of MTX-LPD in the oral cavity. Homogeneous hyperintensity on fat-suppressed T2-weighted images and low ADC values are possible features of MTX-LPD. Moreover, MTX-LPD can be differentiated from other carcinomas in the oral cavity.
ISSN:0911-6028
1613-9674
DOI:10.1007/s11282-022-00626-x