Reviewer ’s report  
 
Title: Methot rexate -associated lymphoproliferative disorder in the stomach and duodenum: A 
case report  
 
Version: 0 Date: 09 Oct 2018  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER R EVIEWER ASSESSMENTS:  
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
No - there are minor issues  
 
DESIGN - Is the current approach ( including controls and analysis protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
No - there are minor issues  
 
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
No - there are minor issues  
 
OVERALL MANUSCRIPT POTENTIAL - Could an appropriately REVISED version of this 
work represent a technically sound contributi on? 
Probably - with minor revisions  
 
PEER REVIEWER COMMENTS:  
GENERAL COMMENTS: Some minor revisions are needed.  
 
REQUESTED REVISIONS:  
1. The keywords include Epstein -Barr virus. It would be better to remove Epstein -Barr virus 
(EBV) to stress that the re ported case is instead classified as a MTX -LPD. Nevertheless the 
reported patients tested negative for EBV (i.e., ISH negative).  
 
2. Since this report describes a single case, the therapeutic effect of the chemo -immunotherapy  
(i.e., R -CHOP) on LPD as well as RA could be considered  
 
3. Of note, it could be useful to describe the differentiated WBC count with particular regard to 
lymphocyte count.  
 
4. Consistent with point 1, the discussion on EBV -LPD could be shortened.  
 
5. With regard to ISH studies, it could be better to report the % of positivity.  
 
6. It could be discussed that CD5+DLBCL is associated with a more aggressive outcome with 
respect to CD5 -DLBCL  
Note: This reviewer report can be downloaded - see attached pdf file.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
  
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additio nal statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain  or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the fut ure? 
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of  the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
This reviewer has been recruited b y a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution License 
attributed to Research Square and was paid a small honorarium for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is ac cepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommo ns.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Methot rexate -associated lymphoproliferative disorder in the stomach and duodenum: A 
case report  
 
Version: 0 Date: 09 Oct 2018  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER R EVIEWER ASSESSMENTS:  
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
No - there are minor issues  
 
DESIGN - Is the current approach ( including controls and analysis protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
No - there are minor issues  
 
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
No - there are minor issues  
 
OVERALL MANUSCRIPT POTENTIAL - Could an appropriately REVISED version of this 
work represent a technically sound contributi on? 
Probably - with minor revisions  
 
PEER REVIEWER COMMENTS:  
GENERAL COMMENTS: Some minor revisions are needed.  
 
REQUESTED REVISIONS:  
1. The keywords include Epstein -Barr virus. It would be better to remove Epstein -Barr virus 
(EBV) to stress that the re ported case is instead classified as a MTX -LPD. Nevertheless the 
reported patients tested negative for EBV (i.e., ISH negative).  
 
2. Since this report describes a single case, the therapeutic effect of the chemo -immunotherapy  
(i.e., R -CHOP) on LPD as well as RA could be considered  
 
3. Of note, it could be useful to describe the differentiated WBC count with particular regard to 
lymphocyte count.  
 
4. Consistent with point 1, the discussion on EBV -LPD could be shortened.  
 
5. With regard to ISH studies, it could be better to report the % of positivity.  
 
6. It could be discussed that CD5+DLBCL is associated with a more aggressive outcome with 
respect to CD5 -DLBCL  
Note: This reviewer report can be downloaded - see attached pdf file.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
  
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additio nal statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain  or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the fut ure? 
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of  the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
This reviewer has been recruited b y a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution License 
attributed to Research Square and was paid a small honorarium for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is ac cepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommo ns.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Methot rexate -associated lymphoproliferative disorder in the stomach and duodenum: A 
case report  
 
Version: 0 Date: 09 Oct 2018  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER R EVIEWER ASSESSMENTS:  
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
No - there are minor issues  
 
DESIGN - Is the current approach ( including controls and analysis protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
No - there are minor issues  
 
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
No - there are minor issues  
 
OVERALL MANUSCRIPT POTENTIAL - Could an appropriately REVISED version of this 
work represent a technically sound contributi on? 
Probably - with minor revisions  
 
PEER REVIEWER COMMENTS:  
GENERAL COMMENTS: Some minor revisions are needed.  
 
REQUESTED REVISIONS:  
1. The keywords include Epstein -Barr virus. It would be better to remove Epstein -Barr virus 
(EBV) to stress that the re ported case is instead classified as a MTX -LPD. Nevertheless the 
reported patients tested negative for EBV (i.e., ISH negative).  
 
2. Since this report describes a single case, the therapeutic effect of the chemo -immunotherapy  
(i.e., R -CHOP) on LPD as well as RA could be considered  
 
3. Of note, it could be useful to describe the differentiated WBC count with particular regard to 
lymphocyte count.  
 
4. Consistent with point 1, the discussion on EBV -LPD could be shortened.  
 
5. With regard to ISH studies, it could be better to report the % of positivity.  
 
6. It could be discussed that CD5+DLBCL is associated with a more aggressive outcome with 
respect to CD5 -DLBCL  
Note: This reviewer report can be downloaded - see attached pdf file.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
  
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additio nal statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain  or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the fut ure? 
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of  the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
This reviewer has been recruited b y a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution License 
attributed to Research Square and was paid a small honorarium for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is ac cepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommo ns.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant