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Annals of Hematology

, Volume 98, Issue 5, pp 1305–1307 | Cite as

Oral ulceration: an unusual manifestation of lymphomatoid granulomatosis

  • Keisuke Kidoguchi
  • Mariko Yoshimura
  • Kensuke KojimaEmail author
  • Hiroshi Ureshino
  • Ryoko Egashira
  • Masako Yokoo
  • Keita Kai
  • Yoshiaki Egashira
  • Koichi Ohshima
  • Toshihiko Ando
  • Shinya Kimura
Letter to the Editor
  • 86 Downloads

Dear Editor,

Lymphomatoid granulomatosis (LYG) is a rare angiocentric and angiodestructive lymphoproliferative disorder (LPD) caused by latent Epstein-Barr virus (EBV) reactivation in immunosuppressed individuals [ 1]. Methotrexate (MTX) has been associated with the development of LPDs. In contrast to pulmonary involvement occurring in > 90% patients with LYG, involvement of oral cavity is extremely rare [ 2, 3]. We report two cases of oral cavity ulceration as an initial clinical manifestation of LYG.
  • Case 1: A 68-year-old man with a history of rheumatoid arthritis (RA) presented with mandibular pain over 1 month in a private dental clinic. He had been treated with MTX and prednisolone (PSL) for 10 years. Intraoral examination revealed an ulcer on the floor of the mouth (Fig. 1a). He was diagnosed with ulcer associated with periodontal disease. One month later, he was referred to us because of refractory oral ulcer. Chest X-ray screening showed bilateral multiple patchy infiltration...

Notes

Funding

This work was supported in part by grants from the Ministry of Education, Culture, Sports, Science, and Technology in Japan (17K09928 0001), the Yasuda Medical Foundation, the Foundation for Promotion of Cancer Research in Japan, and the Project Mirai Cancer Research Grants.

Compliance with ethical standards

Written informed consent was obtained from the patients for publication.

Conflict of interest

The authors declare that they have no conflict of interest.

References

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Keisuke Kidoguchi
    • 1
  • Mariko Yoshimura
    • 1
  • Kensuke Kojima
    • 1
    Email author
  • Hiroshi Ureshino
    • 1
  • Ryoko Egashira
    • 2
  • Masako Yokoo
    • 1
  • Keita Kai
    • 3
  • Yoshiaki Egashira
    • 2
  • Koichi Ohshima
    • 4
  • Toshihiko Ando
    • 1
  • Shinya Kimura
    • 1
  1. 1.Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of MedicineSaga UniversitySagaJapan
  2. 2.Department of Radiology, Faculty of MedicineSaga UniversitySagaJapan
  3. 3.Department of PathologySaga University HospitalSagaJapan
  4. 4.Department of Pathology, School of MedicineKurume UniversityKurumeJapan

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