Presentation
History of anaplastic large cell lymphoma, had high dose methotrexate therapy.
Patient Data
Age: 13 years
Gender: Female
From the case:
Methotrexate-related leukoencephalopathy and myelopathy
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Patchy T1 hypointense, T2W / FLAIR hyperintense signals of white matter, more confluent at bilateral centrum semiovale with sparing of subcortical U-fibers. Minimal T2W / FLAIR hyperintense signals are also seen at periventricular and genu of corpus callosum. No restricted diffusion. No focal enhancing intracranial lesion. No abnormal leptomeningeal enhancement.
Case Discussion
Therapeutic drug monitoring for methotrexate was above the toxicity limit. Serum B12 and copper levels were not available.
With the given clinical information, overall findings are in favor of methotrexate-related leukoencephalopathy and myelopathy.
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