Two cases suspected of methotrexate-associated lymphoproliferative disorders of the lung
Takashi Shimizua Takafumi Tetsukab Kazuhiko Itob Yasuharu Saitoa Hiroki Tsukadab Tetsuro Ohdairaa
aDepartment of Respiratory Center, Nishi-Niigata Chuo National Hospital
bDepartment of Respiratory Medicine, Niigata City General Hospital
Methotrexate (MTX) has been reported to increase the risk of lymphoproliferative disorders (LPD). We report two cases that were diagnosed as MTX-associated LPD. Case 1: A 76-year-old man with active rheumatoid arthritis (RA) had been treated with MTX for 3 years, and chest CT revealed multiple pulmonary nodules. Case 2: A 68-year-old woman with active RA had been treated with MTX for 10 years, and CT revealed a multiple pulmonary tumor. Abdominal CT revealed a liver and adrenal tumor. A lung biopsy was performed in both cases. In the histological findings, a large part of the lung tumor had undergone necrosis, and immunohistological findings show a positive exhibition of CD20. Withdrawal of MTX led the two patients to achieve complete remission.
Methotrexate-associated lymphoproliferative disorders Methotrexate Lymphoproliferative disorders Lymphoma Rheumatoid arthritis
Received 1 Aug 2013 / Accepted 31 Oct 2013
AJRS, 3(2): 245-250, 2014