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Cardiac Methotrexate-Induced Lymphoproliferative Disorder.
Daisuke Kaneyuki1, Atsushi Iguchi1, Chiho Tokunaga1
1Division of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
The Annals of Thoracic Surgery
|March 12, 2019
Summary
This case report details the first instance of cardiac lymphoproliferative disorder caused by methotrexate. Early differentiation from sinus of Valsalva aneurysm rupture is crucial for timely intervention and treatment.
Area of Science:
- Cardiology
- Oncology
- Immunology
Background:
- Methotrexate is an immunosuppressive drug linked to lymphoproliferative disorders.
- Cardiac involvement in methotrexate-induced lymphoproliferative disorders is rare.
Observation:
- A patient presented with a condition mimicking sinus of Valsalva aneurysm rupture.
- Cardiac magnetic resonance imaging and 18F-FDG PET/CT were used for differentiation.
- A tissue biopsy during aneurysm repair confirmed the diagnosis.
Findings:
- The condition was identified as a cardiac methotrexate-induced lymphoproliferative disorder.
- Complete regression of the disorder was observed after discontinuing methotrexate.
- This represents the first documented case of its kind in the heart.
Implications:
- Highlights the importance of considering methotrexate-induced lymphoproliferative disorders in cardiac cases.
- Emphasizes the role of advanced imaging and biopsy in diagnosis.
- Suggests methotrexate withdrawal as an effective treatment strategy.
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