Nucl Med Mol Imaging.  2017 Sep;51(3):261-265. 10.1007/s13139-016-0463-4.

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

• Makis W
• Ciarallo A
• Wang B
• Gonzalez-Verdecia M
• Probst S

• KMID: 2396586
• DOI: http://doi.org/10.1007/s13139-016-0463-4

Abstract

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 (¹â¸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.

Keyword

Composite lymphoma; Cutaneous lymphoma; Iatrogenic immunodeficiency-associated lymphoproliferative disorder; Methotrexate; PET/CT; Rheumatoid arthritis

MeSH Terms

Arthritis, Rheumatoid*
Composite Lymphoma
Drug Therapy
Electrons
Female
Humans
Lymphoma*
Lymphoproliferative Disorders
Methotrexate*
Positron-Emission Tomography and Computed Tomography*
Prednisone
Skin
Methotrexate
Prednisone