A Resected Case of Methotrexate-Associated Lymphoproliferative Disorder Originated from Hepatoduodenal Lymph Node

Abstract

A 73-year-old man with a 6-cm tumor extending from the hepatic hilum to the pancreatic head was referred to our hospital for a detailed examination. Endoscopic ultrasound fine-needle aspiration was performed ; however, a definitive diagnosis was not obtained. Therefore, a laparoscopic tumorectomy was performed. Intraoperative findings showed that the tumor was an enlarged hepatoduodenal ligament lymph node. Histopathological findings indicated a nodular sclerosing Hodgkin lymphoma. We diagnosed him with a methotrexate-associated lymphoproliferative disorder owing to his methotrexate administration for rheumatoid arthritis. Methotrexate was discontinued postoperatively, and he patient has been observed without treatment for lymphoma. At 25 months postoperatively, he remains alive without recurrence.