A case of methotrexate-associated Hodgkin's lymphoma of the submental lymph nodes

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  • ISHIBASHI Kenichiro
    Department of Oral and Maxillofacial Surgery, Inazawa City Hospital Department of Dentistry and Oral Surgery, Toyohashi Municipal Hospital
  • TERASAWA Humitaka
    Department of Dentistry and Oral Surgery, Toyohashi Municipal Hospital
  • MOON Mawoomi
    Department of Dentistry and Oral Surgery, Toyohashi Municipal Hospital
  • SHIROZU Takamasa
    Department of Dentistry and Oral Surgery, Toyohashi Municipal Hospital
  • SAKUMA Hidenori
    Department of Dental Hygiene Ogaki Women's College
  • KAETSU Atsuo
    Department of Dentistry and Oral Surgery, Toyohashi Municipal Hospital

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Other Title
  • オトガイ下リンパ節に生じたMTX関連ホジキンリンパ腫の1例
  • オトガイ カ リンパセツ ニ ショウジタ MTX カンレン ホジキン リンパシュ ノ 1レイ

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Description

Recently methotrexate (MTX) has been increasingly administered to patients with rheumatoid arthritis (RA). However, it has been well documented that there is a risk of the development of lymphomas in these patients. We report a case of Hodgkin's lymphoma (HL) of the submental lymph nodes in a 76-year-old man who was receiving low-dose MTX for RA. He presented at our hospital because of severe periodontitis in the right lower gum. A biopsy specimen of the right lower gum showed only granulomatous inflammation. Four months later, the patient developed submental lymphadenopathy. Lymph node biopsy revealed the presence of mixed cellularity type of HL. Immunohistochemistry showed that the large atypical cells were positive for CD30 and Epstein-Barr virus early RNA (EBER) and negative for CD3 and CD20. Radiotherapy was immediately performed, and there have been no signs of recurrence for 30 months after radiotherapy.

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