Imaging using diffusion-weighted whole-body imaging with background signal suppression for methotrexate-associated lymphoproliferative disorder: A case report

Takeshi Mochizuki; Naoko Otani; Mari Ando; Ryo Hiroshima; Koichiro Yano; Katsunori Ikari; Ken Okazaki

doi:10.1093/mrcr/rxae078

Imaging using diffusion-weighted whole-body imaging with background signal suppression for methotrexate-associated lymphoproliferative disorder: A case report

Mod Rheumatol Case Rep. 2024 Dec 9:rxae078. doi: 10.1093/mrcr/rxae078. Online ahead of print.

Authors

Takeshi Mochizuki¹, Naoko Otani¹, Mari Ando¹, Ryo Hiroshima¹, Koichiro Yano², Katsunori Ikari², Ken Okazaki²

Affiliations

¹ Department of Orthopaedic Surgery and Rheumatology, Kamagaya General Hospital, Chiba, Japan.
² Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.

PMID: 39657696
DOI: 10.1093/mrcr/rxae078

Abstract

Patients with rheumatoid arthritis (RA) receiving immunosuppressive therapy including methotrexate (MTX), are at risk of developing lymphoproliferative disorder (LPD). Herein, we report the case of a 61-year-old man who has been treated with MTX and sulfasalazine for seropositive RA since the age of 52. He underwent diffusion-weighted whole-body imaging with background signal suppression (DWIBS), which revealed high-intensity lesions in the affected lymph nodes of the cervical, clavicular, and axillary regions. Follow-up DWIBS after MTX withdrawal showed the suppression or disappearance of the high-intensity lesions. This case demonstrates the potential of DWIBS as a new standard imaging modality for MTX-LPD in patients with RA in clinical practice.

Keywords: DWIBS; lymphoproliferative disorder; methotrexate; rheumatoid arthritis.

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