title: [B-cell lymphoma possessing t(14;18)(q32;q21)in a patient with rheumatoid arthritis receiving methotrexate treatment].
abstract: There is evidence of a slight increase in malignant lymphoma among rheumatoid arthritis(RA)patients receiving methotrexate( MTX). Increased rates of lymphoma have been attributed to reactivation of the Epstein-Barr virus(EBV). A 72-yearold woman was admitted to our hospital for generalized lymph adenopathy. She suffered from RA and has been treated with MTX for 7 years; the total amount of MTX received was around 2, 700 mg. The cervical lymph node revealed a diffuse proliferation of large atypical lymphocytes. An immunophenotype revealed CD10+, CD19+, CD20+, and k+. The chromosome analysis showed a complex abnormality containing t(14;18)(q32;q21). The tumor cells were positive for EBV sequences by in situ hybridization(ISH). A rituximab containing regimen was effective, but a systemic relapse occurred 4 years later. The biopsied sample was diagnosed as diffuse large B-cell lymphoma. FISH analysis revealed positive for t(14;18)(q32;q21), however, EBV was negative using ISH. In general, the concurrence of t(14;18)(q32;q21)and EBV in the B-cell lymphoma is rare. In addition, the negative change in EBV in the relapsed lymphoma cells revealed a quite rare phenomenon.
authors.affiliation: Dept. of Internal Medicine, Matsuyama Red Cross Hospital.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Nakanishi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Muta
authors.forename: Yumi
authors.initials: Y
authors.lastname: Oshiro
authors.forename: Akira
authors.initials: A
authors.lastname: Hida
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Megumi
authors.initials: M
authors.lastname: Yasunaga
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ueda
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Fujisaki
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D001706:Biopsy; D002883:Chromosomes, Human, Pair 14; D002887:Chromosomes, Human, Pair 18; D005260:Female; D004854:Herpesvirus 4, Human / Q000502:physiology; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications / Q000235:genetics* / Q000473:pathology / Q000821:virology; D008727:Methotrexate / Q000627:therapeutic use*
chemical_list: D008727:Methotrexate