Naso-Maxillary Non-Hodgkin Lymphoma Associated With Methotrexate Treatment in a Patient With Rheumatoid Arthritis

Reversible methotrexate-associated lymphoproliferative disorder (MTX-LPD) associated with Epstein–Barr virus in a patient with rheumatoid arthritis

“…MTX-LPD has been reported by several papers in the head and neck region but those in the tongue are rare [1,2,[7][8][9][10]. In this case, MTX-LPD arose as an ulcer of the tongue.…”

“…In about 40% of the reported cases, the affected sites have been extranodal, including the gastrointestinal tract, skin, lung, kidney, and soft tissues [1,2,4,7]. MTX-LPD has been reported by several papers in the head and neck region but those in the tongue are rare [1,2,[7][8][9][10].…”

“…Recently, it has been shown that RA patients treated with MTX are at increased risk of developing lymphoproliferative disorders (MTX-LPD) [1,2]. LPD occasionally develops in individuals with immune deficiencies.…”

“…These diseases are categorized as immunodeficiency-associated LPD in the recent World Health Organization (WHO) classification for lymphoid neoplasms. Iatrogenic immunosuppression associated with MTX administration is one of the immunosuppressive conditions seen prior to LPD [1][2][3]. However, as recent research shows, little is known about the clinicopathological findings of MTX-LPD mimicking malignant lymphoma, especially in the head and neck region [4][5][6].…”

Spontaneous complete remission of methotrexate-associated extranodal B-cell lymphoma of the buccal mucosa: Review of the literature and report of a case

“…Several researchers have pointed out that immunosuppressive therapy for patients with RA, which is an immunodeficiency disorder, has long been implicated in the development of lymphoma, as so-called MTX-associated lymphoproliferative disorder (MTX-LPD) [3][4][5]. The underlying mechanism has been theorized to involve severe immunosuppression and an increased frequency of latent infection with pro-oncogenic viruses such as Epstein-Barr virus (EBV) [6,7].…”