Abstract
Methotrexate （MTX） is administered to patients with rheumatoid arthritis （RA） as standard treatment. Tumor necrosis factor （TNF） antagonist, which was recently approved for use in Japan, also shows excellent clinical effectiveness. However, these agents may increase the risk of malignant lymphoma. We report a case of methotrexate-associated lymphoproliferative disorder （MTX-LPD） after chemotherapy with MTX and TNF antagonists. A 52-year-old woman presented because of pain in the left oral floor with an ulcer in June 2009. The patient had received MTX therapy for RA for 3 years since 2006, as well as TNF antagonists for 2 years from 2007. The diagnosis of‘ diffuse large B-cell lymphoma’ was established by biopsy of the focus. MTX therapy was discontinued on consultation with her doctor, and the ulcer disappeared in 4 months without any further chemotherapy for lymphoma.
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