Chest
Selected ReportsMethotrexate-Induced Pulmonary Lymphomaa
Section snippets
Case Report
A 54-year-old man received a diagnosis of RA 12 years earlier, and had been treated with methotrexate for the past 5 years. The initial dosage was 7.5 mg every week and was later increased to 20 mg. He also received nabumetone, 1 g bid for 1 year, and prednisone, 5 mg/d for the past 12 years. His other significant medical history included hypothyroidism and 30 pack-years of cigarette smoking. He quit smoking 3 years ago and has remained a nonsmoker since then. The patient did not use any
Discussion
Methotrexate is a structural analog of folic acid that inhibits the enzyme dihydrofolate reductase, thereby blocking the conversion of dihydrofolate to tetrahydrofolate.8Cellular proliferation is reduced. The effects are most prominent in tissues with high mitotic rates, as occurs in malignant tumors, bone marrow, testes, GI tract, and the bladder mucosa.9It also has anti-inflammatory and immunomodulating properties38; however, the exact mechanism by which it improves the signs and symptoms of
Conclusion
In the absence of a large controlled study confirming the association of methotrexate therapy in RA and diffuse B-cell lymphoma, we hope our report will stimulate other clinicians to be vigilant in monitoring the emergence of lymphoproliferative disorder as more patients with RA are treated with methotrexate. We suspect that methotrexate has an oncogenic potential even in low weekly dosing in a subset of patients with RA and latent Epstein-Barr virus infection. The strongest causal link was
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Cited by (42)
The incidence and prognosis of other iatrogenic immunodeficiency-associated lymphoproliferative disorders of the lung related to methotrexate: A retrospective study
2024, Pulmonary Pharmacology and TherapeuticsAn effective nanoparticles for drug delivery system
2021, Materials Today: ProceedingsCitation Excerpt :MTX C20H22N8O5 formerly known as Amethopterin having molecular weight of 454.44 g/mol is used in the treatment of cancer because it stops cell division, DNA repairing and cell working.[27] MTX is an effective drug to treat types of cancers such as leukemia, lymphoma, breast cancer, lung cancer, etc. [28–36]. It is also exploited to treat autoimmune diseases such as psoriasis, rheumatoid arthritis etc.
Psoriasis: Which therapy for which patient: Psoriasis comorbidities and preferred systemic agents
2019, Journal of the American Academy of DermatologyCitation Excerpt :In a long-term study of 248 psoriasis patients treated with methotrexate, 10 patients developed malignant neoplasms including lymphomas, but this study concluded that methotrexate therapy for psoriasis did not contribute to the development of neoplasms.71 However, there are several reports of newly diagnosed Epstein–Barr virus–associated lymphomas in patients with psoriasis who were taking methotrexate.72-75 Long-term high-dose cyclosporine is associated with solid organ, skin, and lymphoproliferative cancers in transplant recipients.
A case of rheumatoid nodules in the buccal subcutaneous : A novel case report of review and the literature
2018, Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyCitation Excerpt :On the other hand, the use of methotrexate (MTX) for RA can cause lymphoma during treatment. The primary site of the MTX-induced lymphoma can be various tissues such as those of the lung [8,9], axillary lymph nodes [10], ovary [11], and lower lip [12]. We suspected Wegener's granulomatosis, IgG4-related diseases, or malignant lymphoma from his biopsy and initial pathological findings.
The risk of melanoma and hematologic cancers in patients with psoriasis
2017, Journal of the American Academy of DermatologyCitation Excerpt :Most studies have shown no increased risk for lymphoma or cutaneous neoplasm with methotrexate use in psoriasis (Table VI).31,32 There have, however, been several case reports indicating an association between lymphoproliferative malignancy and methotrexate use.33-36 An Australian study found a 3-fold increased risk of melanoma (standardized incidence ratio [SIR] 3.0, 95% CI 1.2-6.2) and 5-fold increased risk for non-Hodgkin lymphoma (SIR 5.1, 95% CI 2.2-10.0) in patients with RA exposed to methotrexate.37
The risk of cancer in patients with psoriasis: A population-based cohort study in Taiwan
2011, Journal of the American Academy of DermatologyCitation Excerpt :Broadband and narrowband UVB do not appear to increase the risk of squamous cell carcinoma.36,37 Recently, development of lymphomas after methotrexate38-40 and cyclosporine,41-47 and remission of lymphomas after withdrawal of these drugs48-51 in psoriasis patients have been reported. We demonstrated that PUVA and systemic therapies do not significantly increase the risk of cancer.
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