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Case Reports
. 2001 Sep;60(9):892-3.

Lymphoma in a patient with rheumatoid arthritis receiving methotrexate treatment: successful treatment with rituximab

M Stewart  1 , V Malkovska, J Krishnan, L Lessin, W Barth
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Case Reports

Lymphoma in a patient with rheumatoid arthritis receiving methotrexate treatment: successful treatment with rituximab

M Stewart et al. Ann Rheum Dis. 2001 Sep.

Abstract

A 55 year old man with chronic lymphocytic leukaemia (CLL) and rheumatoid arthritis (RA), treated for four years with methotrexate (MTX), who developed a B cell non-Hodgkin's lymphoma (B-NHL), is described. The tumour was localised to the shoulder and axillary lymph nodes, and positive for Epstein-Barr viral antigens. After failure of radiation and chemotherapy, a complete remission was achieved with a combination of antibody treatment (rituximab) and EPOCH. The development of a second malignancy in a patient with RA receiving MTX has not been described before. The summation of T cell deficiencies induced by MTX, CLL, and RA may all have contributed to the development of the B-NHL.

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