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Methotrexate-associated lymphoproliferative disorder demonstrating composite lymphoma of EBV-negative diffuse large
Keiichi Moriya1,2, Yara Yukie Kikuti2, Joaquim Carreras2
1Department of Hematology, Shinmatsudo Central General Hospital, Matsudo, Japan.
Abstract:
Other iatrogenic immunodeficiency-associated lymphoproliferative disorders induced by immunosuppressive drugs, such as methotrexate (MTX-LPD), exhibit numerous pathological findings. We report the case of an 81-year-old Japanese woman diagnosed with MTX-LPD exhibiting two distinct pathological features from two different sites. Excisional biopsy of the left cervical lymph node revealed EBV-negative diffuse large B-cell lymphoma and biopsy of a pharyngeal ulcer revealed EBV-positive mucocutaneous ulcer. She was treated using an R-CHOP regimen and maintained complete remission for years. This case demonstrates the heterogeneous pathology of MTX-LPD and suggests the necessity of multiple biopsy.
