[Three cases of methotrexate-associated lymphoproliferative disorder (MTX-LPD)].
Methotrexate (MTX) has been increasingly administered to patients with rheumatoid arthritis (RA), resulting in methotrexate-associated lymphoproliferative disorder (MTX-LPD) in patients. We reported three case of rheumatoid arthritis (RA) undergoing methotrexate (MTX) therapy who developed MTX-LPD. A 72-year-old woman treated with MTX since December 1997 (total dose 3684 mg) presented with swelling of the right tonsil in October 2006, and diffuse large B-cell lymphoma was diagnosed by tonsil biopsy and positive EBER1. When MTX therapy was interrupted, the tonsil was shrank and chemotherapy was not necessary. She followed a good clinical course for 12 months. Two other patients treated with MTX for RA for several years presented with enlarged neck lymph nodes and were diagnosed with MTX-LPD. Neck lymph nodes shrank upon MTX withdrawal in several weeks. There have been no signs of recurrence in these cases and they followed a good clinical course. The oncogenic potential of MTX and RA is reviewed.
Ishida
Yoshiya
Y
Department of Otolaryngology-Head and Neck Surgery, Kitami Red Cross Hospital, Kitami.
Asahi
Atsuyoshi
A
Wada
Tetsuji
T
Kanai
Naoki
N
Kobayashi
Yuuki
Y
Moriai
Shigetaka
S
Kishibe
Kan
K
Harabuchi
Yasuaki
Y
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D005260:Female; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000139:chemically induced*; D008727:Methotrexate / Q000009:adverse effects*
D008727:Methotrexate