title: Methotrexate-associated mantle-cell lymphoma in an elderly man with myasthenia gravis.
abstract: BACKGROUND
  A 75-year-old man on methotrexate immunosuppression for myasthenia gravis presented with a 2-month history of lymphocytosis and bilateral inguinal adenopathy. There were no constitutional symptoms of fever, night sweats, or weight loss.
  
  
  METHODS
  Physical examination, blood tests, flow cytometry, fluorescent in situ hybridization, immunoglobulin gene sequencing, viral load quantification by real-time polymerase chain reaction, excisional lymph-node biopsy, bone-marrow biopsy, tumor morphology and immunohistochemistry, sequential CT and PET scans.
  
  
  METHODS
  Methotrexate-associated mantle-cell lymphoma.
  
  
  RESULTS
  Cessation of methotrexate, anthracycline-based combination chemo-immunotherapy, and maintenance rituximab.
authors.affiliation: Princess Alexandra Hospital, Brisbane, Australia.
authors.forename: Huy
authors.initials: H
authors.lastname: Tran
authors.forename: Catherine
authors.initials: C
authors.lastname: Cheung
authors.forename: Devinder
authors.initials: D
authors.lastname: Gill
authors.forename: Ujjwal
authors.initials: U
authors.lastname: Dua
authors.forename: Jamie
authors.initials: J
authors.lastname: Nourse
authors.forename: Richard
authors.initials: R
authors.lastname: Boyle
authors.forename: Maher K
authors.initials: MK
authors.lastname: Gandhi
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008214:Lymphocytes; D008218:Lymphocytosis / Q000139:chemically induced; D020522:Lymphoma, Mantle-Cell / Q000139:chemically induced* / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D009157:Myasthenia Gravis / Q000188:drug therapy*; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents; D008727:Methotrexate