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Four years after the onset of sarcoidosis, the patient presented a large necrotizing anal fistula. Pathological examination of this lesion showed a diffuse polymorphic infiltrate containing large Epstein\u2013Barr virus (EBV)\u2010positive lymphoid cells associated with areas of necrosis, all features similar to classical B\u2010cell lymphoproliferative disorders occurring in immunosuppressed solid\u2010organ recipients. MTX has been recently implicated in the development of lymphoproliferative disease in connective tissue diseases. This case supports the hypothesis that immunosuppression therapy may contribute to an increased risk for the development of EBV\u2010associated lymphoproliferative disorders in patients suffering from sarcoidosis.<\/jats:p>","DOI":"10.1034\/j.1600-0609.2002.02748.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T18:53:29Z","timestamp":1047408809000},"page":"248-253","source":"Crossref","is-referenced-by-count":22,"title":["Epstein\u2013Barr virus\u2010associated lymphoproliferative disease occurring in a patient with sarcoidosis treated by methotrexate and 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