Department of General Internal Medicine and Rheumatology, Clinical Research Center, NHO National Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan.
Mod Rheumatol. 2013 Jul;23(4):832-6. doi: 10.1007/s10165-012-0717-7. Epub 2012 Jul 24.
Patients with rheumatoid arthritis (RA), especially those treated with methotrexate (MTX), might have an increased risk of lymphoproliferative disorders that are associated with Epstein-Barr virus (EBV). We describe a case of EBV-associated central nervous system (CNS) lymphoma (diffuse large B-cell lymphoma) in a patient with RA on a short course of MTX treatment. The neoplastic cells express the B-cell surface markers (CD20, Pax-5 and CD30), and EBV-encoded RNA was demonstrated by in situ hybridization. The patient's lymphoma did not recur for the 8-year follow-up period after the tumor resection and cessation of MTX. MTX may promote EBV-positive CNS lymphoma in RA patient due to its immunosuppressive properties as well as reactivating latent EBV infection.
类风湿关节炎（RA）患者，尤其是接受甲氨蝶呤（MTX）治疗的患者，可能会增加与 EBV 相关的淋巴增生性疾病的风险。我们描述了 1 例 RA 患者在接受短期 MTX 治疗期间发生 EBV 相关中枢神经系统（CNS）淋巴瘤（弥漫性大 B 细胞淋巴瘤）的病例。肿瘤细胞表达 B 细胞表面标志物（CD20、Pax-5 和 CD30），原位杂交显示 EBV 编码的 RNA 阳性。在肿瘤切除和停用 MTX 后 8 年的随访期间，患者的淋巴瘤未复发。MTX 可能通过其免疫抑制特性以及激活潜伏 EBV 感染，促进 RA 患者 EBV 阳性 CNS 淋巴瘤的发生。
