2010
DOI: 10.1200/jco.2010.28.3796
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Primary Cutaneous Epstein-Barr Virus–Associated B-Cell Lymphoma Arising at the Site of Subcutaneous Injections of Methotrexate

Abstract: A 71-year-old woman had had dermatomyositis since 2001. The diagnosis was made on the association of diffuse arthralgia, proximal muscle weakness, periorbital reddish edema, erythematous papules over the metacarpophalangeal and interphalangeal joints, elevated serum muscle enzyme levels, presence of anti-JO1 antibodies, and suggestive changes on muscle biopsy and electromyogram. No neoplasm was present. She was initially treated with progressively decreasing doses of oral steroids and maintenance posology of 1… Show more

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Cited by 16 publications
(17 citation statements)
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“…These lymphomas are multifocal and tend to regress on withdrawing the methotrexate. This strict relationship was highlighted more strongly in a case of an EBV‐positive cutaneous B‐cell lymphoma occurring specifically at the site of methotrexate injection . The lesion promptly regressed on withdrawing the offending drug.…”
Section: Resultsmentioning
confidence: 96%
See 1 more Smart Citation
“…These lymphomas are multifocal and tend to regress on withdrawing the methotrexate. This strict relationship was highlighted more strongly in a case of an EBV‐positive cutaneous B‐cell lymphoma occurring specifically at the site of methotrexate injection . The lesion promptly regressed on withdrawing the offending drug.…”
Section: Resultsmentioning
confidence: 96%
“…A 3‐fold increased risk of malignant melanoma has been described in methotrexate‐exposed rheumatology patients . A number of case reports have underlined this association . As no data are available in the IBD literature, it could be potentially hazardous to extrapolate this risk from rheumatology to IBD subjects.…”
Section: Resultsmentioning
confidence: 99%
“…Approximately 40% are extranodal, including a recent unusual case of one developing at the site of subcutaneous injection of MTX. 9 However, both here and indeed throughout this discussion, questions arise as to whether there really is a bona fide association, and if so is there direct evidence of causation, or is this merely coincidence. Although it is essentially accepted as dogma that patients with RA and treated with MTX are indeed at heightened risk for the development of lymphoma, it is sobering to note that large studies, involving a total of over 40,000 patients with RA treated with MTX, 10,11 have failed to document a statistically significant increased risk for lymphoma!…”
Section: Methotrexate-associated Lymphoproliferationsmentioning
confidence: 97%
“…58,[301][302][303] Regarding the morphology of such lymphomas, plasmablastic lymphoma, marginal zone lymphoma, "centroblastic," and diffuse large B-cell lymphoma have been described. 304 Commonly, withdrawal of MTX therapy leads to complete lesional regression. 304 Commonly, withdrawal of MTX therapy leads to complete lesional regression.…”
Section: Methotrexate-associated Lymphoproliferative Diseasementioning
confidence: 99%