2017 Volume 30 Issue 1 Pages 67-71
Patients with rheumatoid arthritis (RA) are known to develop lymphoproliferative disorders (LPDs) during the course of their illness, particularly in cases treated with methotrexate (MTX) for long periods. We describe herein a case of an MTX-related Epstein-Barr-virus associated lymphoproliferative disorder.
A 80-year-old woman presented to the ENT service with a one-month history of a pain in the oropharynx. The patient had a history of RA and had been treated with MTX. On endoscopic examination, a tumorous lesion was observed in the oropharynx. A positron emission tomography/computed tomography (PET/CT) scan showed abnormal accumulation in the same area. Histological analysis showed variant cells, which stained positive for CD3, CD4, CD5, CD8, CD20, and CD79 and negative for CD56. The variant cells also stained positive for EBER-ISH.
Taking those findings together, we diagnosed the patient as having methotrexate associated diffuse large B-cell lymphoma related to Epstein-Barr virus infection.
