EBV-associated synovial lymphoma in a chronically inflamed joint in rheumatoid arthritis receiving prolonged methotrexate treatment.
A patient with longstanding rheumatoid arthritis (RA) developed swelling in a chronically inflamed knee joint while receiving prolonged methotrexate treatment. Magnetic resonance imaging and positron-emission tomography showed soft tissue swelling with intense tracer uptake. Biopsy confirmed high-grade B-cell lymphoma. He developed complete remission with rituximab plus CEOP. The role of chronic inflammation and methotrexate in the pathogenesis of lymphoma in RA was discussed.
Chim
C S
CS
Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong. jcschim@hku.hk
Pang
Y Y
YY
Ooi
G C
GC
Mok
M Y
MY
Shek
T W
TW
D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D020031:Epstein-Barr Virus Infections / Q000139:chemically induced*; D004854:Herpesvirus 4, Human; D006801:Humans; D007719:Knee Joint / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000139:chemically induced*; D008297:Male; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use
D018501:Antirheumatic Agents; D008727:Methotrexate