Methotrexate-associated Lymphoproliferative Disease with Multiple Pulmonary Nodules in a Patient with Rheumatoid Arthritis

Koichiro Suemori; Hitoshi Hasegawa; Jun Ishizaki; Takuya Matsumoto; Sachiko Onishi; Eiji Sada; Atsuro Sugita; Masaki Yasukawa

doi:10.2169/internalmedicine.54.3542

CASE REPORTS

Methotrexate-associated Lymphoproliferative Disease with Multiple Pulmonary Nodules in a Patient with Rheumatoid Arthritis

Koichiro Suemori, Hitoshi Hasegawa, Jun Ishizaki, Takuya Matsumoto, Sachiko Onishi, Eiji Sada, Atsuro Sugita, Masaki Yasukawa

Author information

Koichiro Suemori
Department of Hematology, Clinical Immunology and Infectious Disease, Ehime University Graduate School of Medicine, Japan
Hitoshi Hasegawa
Department of Hematology, Clinical Immunology and Infectious Disease, Ehime University Graduate School of Medicine, Japan
Jun Ishizaki
Department of Hematology, Clinical Immunology and Infectious Disease, Ehime University Graduate School of Medicine, Japan
Takuya Matsumoto
Department of Hematology, Clinical Immunology and Infectious Disease, Ehime University Graduate School of Medicine, Japan
Sachiko Onishi
Department of Hematology, Clinical Immunology and Infectious Disease, Ehime University Graduate School of Medicine, Japan
Eiji Sada
Department of Medical Technology, Ehime Prefectural University of Health Sciences, Japan
Atsuro Sugita
Pathology Division, Ehime University Hospital, Japan
Masaki Yasukawa
Department of Hematology, Clinical Immunology and Infectious Disease, Ehime University Graduate School of Medicine, Japan

Keywords: methotrexate-associated lymphoproliferative disease, rheumatoid arthritis, multiple pulmonary nodules

JOURNAL OPEN ACCESS

2015 Volume 54 Issue 11 Pages 1421-1425

DOI https://doi.org/10.2169/internalmedicine.54.3542

Details

Abstract

Patients with rheumatoid arthritis (RA) treated with methotrexate (MTX) sometimes develop lymphoproliferative disease (LPD). MTX-associated LPD can affect nodal or extranodal sites, including the gastrointestinal tract, skin, lungs, kidneys and soft tissues, at almost equal frequency. However, it is very rare for MTX-associated LPD to manifest as multiple nodules in the lungs. We herein report the case of a RA patient who developed MTX-associated LPD with multiple pulmonary nodules during a 5-year course of MTX therapy.

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