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

Ami Kuribayashi, Sakurako Kawashima, Kou Kayamori, Junichiro Sakamoto, Hiroshi Tomisato, Hiroshi Watanabe, Tohru Kurabayashi

Oral radiology 2023 Apr

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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. 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. 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 mm2/s. 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. © 2022. The Author(s) under exclusive licence to Japanese Society for Oral and Maxillofacial Radiology.

Citation

Ami Kuribayashi, Sakurako Kawashima, Kou Kayamori, Junichiro Sakamoto, Hiroshi Tomisato, Hiroshi Watanabe, Tohru Kurabayashi. Magnetic resonance imaging of methotrexate-related lymphoproliferative disorder with a chief complaint of oral symptoms. Oral radiology. 2023 Apr;39(2):235-241