title: Hodgkin's disease and B cell lymphoproliferation in rheumatoid arthritis patients treated with methotrexate: a kinetic study of lymph node changes.
abstract: We describe 2 patients with seropositive rheumatoid arthritis treated with methotrexate (MTX) who developed Hodgkin's disease (HD) and non-Hodgkin's lymphoma. Followup allowed a lymph node biopsy at 4 different time points in 1 patient and at 2 in the other. In the first patient, the steps included a long history of benign follicle hyperplasia, a polymorphic diffuse B cell lymphoproliferation, and finally HD unassociated with Epstein-Barr virus (EBV). In the second patient, a polymorphic diffuse lymphoproliferation was followed by a monomorphic large B cell lymphoproliferation associated with EBV. The cytogenetic analysis showed a monoclonal proliferation associated with the same chromosomal abnormalities found in 1 of the clones observed in the initial biopsy. These 2 cases illustrate the complexity of the role of MTX in the outbreak of such manifestations.
authors.affiliation: Department of Rheumatology, Hôpital E. Herriot, Lyon, France.
authors.forename: G
authors.initials: G
authors.lastname: Chevrel
authors.forename: F
authors.initials: F
authors.lastname: Berger
authors.forename: P
authors.initials: P
authors.lastname: Miossec
authors.forename: M
authors.initials: M
authors.lastname: Blanc
authors.forename: J
authors.initials: J
authors.lastname: Jeanneret
authors.forename: C
authors.initials: C
authors.lastname: Felman
authors.forename: J
authors.initials: J
authors.lastname: Tebib
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001706:Biopsy; D005260:Female; D006689:Hodgkin Disease / Q000139:chemically induced; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000139:chemically induced; D008232:Lymphoproliferative Disorders / Q000139:chemically induced; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged
chemical_list: D008727:Methotrexate