title: EBV-positive MTX-diffuse large B cell lymphoma in a rheumatoid arthritis patient.
abstract: Methotrexate (MTX)-associated lymphoproliferative disorders have received much attention from rheumatologists, and early diagnosis is very important for reducing mortality. There are several reports of radiologic findings in patients with pulmonary malignant lymphoma, mainly consisting of masses, nodules, and lymphadenopathy. Computed tomography has rarely detected necrosis in the masses. In this article, we report a case of MTX-associated Epstein-Barr virus-positive diffuse large B-cell lymphoma characterized by a very large lung mass with prominent areas of central necrosis. The disease regressed after withdrawal of MTX.
authors.affiliation: Department of Radiology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan, tokuyama@oita-u.ac.jp.
authors.forename: Kouhei
authors.initials: K
authors.lastname: Tokuyama
authors.forename: Fumito
authors.initials: F
authors.lastname: Okada
authors.forename: Shunro
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Hiromu
authors.initials: H
authors.lastname: Mori
authors.forename: Masao
authors.initials: M
authors.lastname: Ogata
authors.forename: Erika
authors.initials: E
authors.lastname: Omote
authors.forename: Toru
authors.initials: T
authors.lastname: Yamasaki
authors.forename: Syougo
authors.initials: S
authors.lastname: Urabe
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D001706:Biopsy; D003287:Contrast Media; D003937:Diagnosis, Differential; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017403:In Situ Hybridization / Q000379:methods; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis*; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D049268:Positron-Emission Tomography / Q000379:methods; D011856:Radiographic Image Enhancement / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D018501:Antirheumatic Agents; D003287:Contrast Media; D008727:Methotrexate