title: [Three cases of methotrexate-associated lymphoproliferative disorder (MTX-LPD)].
abstract: 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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kitami Red Cross Hospital, Kitami.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Ishida
authors.forename: Atsuyoshi
authors.initials: A
authors.lastname: Asahi
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Wada
authors.forename: Naoki
authors.initials: N
authors.lastname: Kanai
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Moriai
authors.forename: Kan
authors.initials: K
authors.lastname: Kishibe
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Harabuchi
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D005260:Female; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000139:chemically induced*; D008727:Methotrexate / Q000009:adverse effects*
chemical_list: D008727:Methotrexate