title: Epstein-Barr virus and methotrexate-related CNS lymphoma in a patient with rheumatoid arthritis.
abstract: Patients with rheumatoid arthritis (RA), especially those treated with methotrexate (MTX), might have an increased risk of lymphoproliferative disorders that are associated with Epstein-Barr virus (EBV). We describe a case of EBV-associated central nervous system (CNS) lymphoma (diffuse large B-cell lymphoma) in a patient with RA on a short course of MTX treatment. The neoplastic cells express the B-cell surface markers (CD20, Pax-5 and CD30), and EBV-encoded RNA was demonstrated by in situ hybridization. The patient's lymphoma did not recur for the 8-year follow-up period after the tumor resection and cessation of MTX. MTX may promote EBV-positive CNS lymphoma in RA patient due to its immunosuppressive properties as well as reactivating latent EBV infection.
authors: Department of General Internal Medicine and Rheumatology, Clinical Research Center, NHO National Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. migita@nmc.hosp.go.jp
authors: Kiyoshi
authors: K
authors: Migita
authors: Taiichiro
authors: T
authors: Miyashita
authors: Toma
authors: T
authors: Mijin
authors: Sohko
authors: S
authors: Sakito
authors: Hirokazu
authors: H
authors: Kurohama
authors: Masahiro
authors: M
authors: Ito
authors: Keisuke
authors: K
authors: Toda
authors: Keisuke
authors: K
authors: Tsustumi
authors: Hiroshi
authors: H
authors: Baba
authors: Yasumori
authors: Y
authors: Izumi
authors: Atsushi
authors: A
authors: Kawakami
authors: Daisuke
authors: D
authors: Niino
authors: Kouichi
authors: K
authors: Ohshima
mesh_terms: D000069594:Abatacept; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D001932:Brain Neoplasms / Q000139:chemically induced* / Q000150:complications / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use; D016403:Lymphoma, Large B-Cell, Diffuse / Q000139:chemically induced* / Q000150:complications / Q000821:virology; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D019233:Retreatment; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D018796:Immunoconjugates; D000069594:Abatacept; D008727:Methotrexate