Abstract
Methotrexate-associated lymphoproliferative disorder (MTX-LPD) is a lymphoid proliferation or lymphoma in a patient immunosuppressed with MTX, which is usually administered for treating autoimmune diseases. The majority of MTX-LPD cases develop in patients with rheumatoid arthritis and occasionally with psoriasis who had been treated with MTX. Here, we report on a 50-year-old Taiwanese male with severe psoriasis, who received high doses of MTX. The patient developed EBV-positive MTX-LPD at nodal and extranodal sites. The diffuse and polymorphic lymphoid infiltrate consisted predominantly of immunoblasts and plasmablasts expressing B-cell markers, CD138, Epstein-Barr virus (EBV)-LMP1, and EBNA2, and these were monotypic for kappa light chain. The tumor cells were also positive for EBV by in situ hybridization. These findings indicated a type III latency infection of EBV. The patient died of progressive disease after 19 months. A review of the previously reported cases shows that MTX-LPD, in association with psoriasis, occurs in middle-aged males. The tumors are diffuse large B-cell lymphomas with immunoblastic morphology, and frequently show plasmacytic differentiation.
Original language | English |
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Pages (from-to) | 43-49 |
Number of pages | 7 |
Journal | Pathology Research and Practice |
Volume | 205 |
Issue number | 1 |
DOIs | |
Publication status | Published - 2009 Jan 15 |
Keywords
- Diffuse large B-cell lymphoma
- Immunodeficiency
- Lymphoproliferative disorder
- Methotrexate
- Psoriasis
ASJC Scopus subject areas
- Pathology and Forensic Medicine
- Cell Biology