A 74-year-old woman with rheumatoid arthritis was urgently admitted to our hospital due to dyspnea. The patient received methotrexate at a dose of 4 mg/week, filgotinib at 200 mg/day and prednisolone at 5 mg/day. On admission, chest CT findings showed diffuse ground glass attenuation in both lung fields; we diagnosed acute exacerbation of interstitial lung disease. Treatment was initiated with prednisolone at 60mg/day; the dose was tapered as the patient’s condition improved. Drug-induced pneumonia was suspected in this case based on laboratory data and clinical course; however, it was difficult to differentiate whether the causative agent was methotrexate, filgotinib, or both.

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The patient is a 54-year-old woman with bronchial asthma. She was diagnosed with a cystic lung lesion through a computed tomography scan and followed up as asymptomatic. Subsequently, she underwent lung wedge resection for infectious lung cysts due to repeated respiratory infections and was diagnosed with congenital pulmonary airway malformation (CPAM). Seven years post-surgery, no recurrence of airway infection or bronchial asthma attacks have occurred, and the patient is doing well. 　It has been reported that CPAM is rarely detected at a relatively old age. Since there have been reports of complications such as infection and malignancy, it is advisable to consider this disease when cystic lung lesions occur and to select treatment methods based on age and complications.

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