Malignant Lymphoma Associated with Rheumatoid Arthritis, Developing Shortly after Initiation of Oral Methotrexate

Takahisa GONO; Yasuhiro SHIMOJIMA; Kenichi HOSHI; Kanji YAMAMOTO; Takahiko TOKUDA; Naoto SHIKAMA; Masayuki MATSUDA; Shu-ichi IKEDA

doi:10.2169/internalmedicine.43.135

Rheumatic Diseases

Malignant Lymphoma Associated with Rheumatoid Arthritis, Developing Shortly after Initiation of Oral Methotrexate

Takahisa GONO, Yasuhiro SHIMOJIMA, Kenichi HOSHI, Kanji YAMAMOTO, Takahiko TOKUDA, Naoto SHIKAMA, Masayuki MATSUDA, Shu-ichi IKEDA

Author information

Keywords: rheumatoid arthritis, malignant lymphoma, methotrexate, CHOP therapy, Epstein-Barr virus, magnetic resonance imaging

JOURNAL OPEN ACCESS

2004 Volume 43 Issue 2 Pages 135-138

DOI https://doi.org/10.2169/internalmedicine.43.135

Details

Abstract

We report a patient with rheumatoid arthritis (RA) who developed malignant lymphoma of the diffuse large B-cell type in the right submandibular region shortly after initiation of oral methotrexate (MTX). Despite cessation of MTX, the lymphadenopathy did not regress, and only reached complete remission after 3 courses of CHOP therapy followed by irradiation. In this patient highly active RA itself was considered to be the main cause of malignant lymphoma, and MTX might have contributed to the development by modifying the immune system. When RA is highly active, MTX should be used carefully because of the possible development of malignant lymphoma as well as other serious complications.

Corresponding author

Register with J-STAGE for free!