Pulmonary non-Hodgkin's lymphoma developed during long-term methotrexate therapy for rheumatoid arthritis

Rheumatol Int. 2012 Nov;32(11):3639-42. doi: 10.1007/s00296-010-1496-0. Epub 2010 Apr 18.


Methotrexate is effective in treating rheumatoid arthritis (RA). Some reports have discussed the possible association between methotrexate and lymphoma. Here, we report a case of pulmonary non-Hodgkin's lymphoma (NHL) developed after 11 years' methotrexate therapy for RA. Biopsy of the pulmonary mass demonstrated a diffuse large B-cell lymphoma. After withdrawal of methotrexate without any other intervention for 4 weeks, a significant reduction in the size of the lymphoma was observed. The causative relationship between methotrexate and pulmonary lymphoma is suggested by the persistent remission after stopping methotrexate therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / pathology
  • Female
  • Humans
  • Lung Neoplasms / chemically induced*
  • Lung Neoplasms / pathology
  • Lymphoma, Non-Hodgkin / chemically induced*
  • Lymphoma, Non-Hodgkin / pathology
  • Methotrexate / adverse effects*
  • Methotrexate / therapeutic use


  • Methotrexate