Reversible Lymphomas Associated with Epstein-Barr Virus Occurring during Methotrexate Therapy for Rheumatoid Arthritis and Dermatomyositis

An increased risk of lymphoproliferative disorders has been well documented in patients who are treated with immunosuppressive agents after organ transplantation1 and in patients with the acquired immunodeficiency syndrome2. The lymphomas that develop in immunosuppressed patients after transplantation are typically large-cell lymphomas that contain Epstein-Barr virus (EBV) and are closely linked to the level of competence of the immune system3. When treatment with immunosuppressive drugs is reduced or discontinued, these EBV-associated lymphomas may regress completely1; if the patient's immune status continues to be compromised, however, the tumor may continue to proliferate and result in death. Whether patients . . .