Lymphoproliferative disorder with pathological fracture of the femur in a patient with rheumatoid arthritis treated with methotrexate: A case report

Oebisu,Naoto; Hoshi,Manabu; Ieguchi,Makoto; Iwai,Tadashi; Tanaka,Sayaka; Osawa,Masahiko; Nakamura,Hiroaki

doi:10.3892/mco.2018.1654

August-2018 Volume 9 Issue 2

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August-2018 Volume 9 Issue 2

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Case Report

Lymphoproliferative disorder with pathological fracture of the femur in a patient with rheumatoid arthritis treated with methotrexate: A case report

Authors:
- Naoto Oebisu
- Manabu Hoshi
- Makoto Ieguchi
- Tadashi Iwai
- Sayaka Tanaka
- Masahiko Osawa
- Hiroaki Nakamura
View Affiliations / Copyright

Affiliations: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Osaka 545‑8585, Japan, Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Osaka 545‑8585, Japan
Pages: 187-191
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Published online on: June 14, 2018

https://doi.org/10.3892/mco.2018.1654
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Abstract

Methotrexate (MTX) is the key drug for the treatment of rheumatoid arthritis (RA). MTX‑treated RA has been associated with the development of lymphoproliferative disorders (LPDs). Notably, the hyperimmune state of RA itself or the immunosuppressive state induced by MTX administration may contribute to development of LPD. Furthermore, Epstein‑Barr virus (EBV) has been indicated to contribute to the development of MTX‑LPD. MTX‑associated LPD (MTX‑LPD) may affect nodal or extranodal sites, including the gastrointestinal tract, skin, lungs, kidneys, and soft tissues, at an almost equal frequency. However, it is rare for MTX‑LPD to manifest as multiple bone tumors with a pathological fracture. The present study reported the case of a 46‑year‑old Japanese woman with RA who had complications of EBV‑positive MTX‑LPD during an approximate 5‑year course of MTX therapy. The present study indicated a rare case in which the LPD had spread to multiple bones in a patient with a pathologic fracture. Notably, the LPD was subclassified as diffuse large B‑cell lymphoma (DLBCL).

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Lymphoproliferative disorder with pathological fracture of the femur in a patient with rheumatoid arthritis treated with methotrexate: A case report

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