Pulmonary and retroperitoneal lesions induced by methotrexate-associated lymphoproliferative disorder in a patient with rheumatoid arthritis.

Abstract

A 78-year-old man had fatigue and appetite loss for 5 months. He had been receiving low-dose methotrexate for rheumatoid arthritis. Computed tomography revealed multiple pulmonary infiltrations and muddiness of the fatty tissue surrounding the right kidney, ureter wall thickening, and hydroureter/nephrosis, which were suspected retroperitoneal fibrosis. Lung biopsy revealed polymorphic/lymphoplasmacytic lymphoproliferative disorder. Methotrexate withdrawal resulted in spontaneous regression. Therefore, retroperitoneal lesion may account for the diagnosis as having retroperitoneal lymphoproliferative disorder, not retroperitoneal fibrosis.

• Authors: Hideaki Yamakawa, Masahiro Yoshida, Hiroaki Katagi, Shinichi Hirooka, Keitaro Okuda, Takeo Ishikawa, Masamichi Takagi, Kazuyoshi Kuwano
• Journal: Modern rheumatology (Mod Rheumatol) Vol. 26 Issue 3 Pg. 441-4 ( 2016) ISSN: 1439-7609 [Electronic] England
• PMID: 24684409 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antirheumatic Agents
• Methotrexate

Topics

• Aged
• Antirheumatic Agents (adverse effects, therapeutic use)
• Arthritis, Rheumatoid (drug therapy, pathology)
• Biopsy
• Humans
• Lung (pathology)
• Lymphoproliferative Disorders (chemically induced, pathology)
• Male
• Methotrexate (adverse effects, therapeutic use)
• Retroperitoneal Fibrosis (chemically induced, pathology)
• Tomography, X-Ray Computed