Methotrexate-associated Lymphoproliferative Disorder: A Rare Differential Diagnosis of Wheezes

A 70-year-old woman was admitted for the evaluation of wheezes and a nodular lesion in the left lung field. She had been diagnosed with rheumatoid arthritis at 45 years of age and was continuously treated with methotrexate (MTX) at 8 mg/week. Bronchoscopic aspiration histology of a hilar lymph node...

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Published inInternal Medicine Vol. 58; no. 12; pp. 1759 - 1764
Main Authors Ujino, Mariko, Miyoshi, Shoki, Sugimoto, Naoya, Arai, Hidenori, Ota, Yasunori, Sasajima, Yuko, Kawamura, Masafumi, Nagase, Hiroyuki, Yamaguchi, Masao, Ohta, Ken
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 15.06.2019
Japan Science and Technology Agency
Subjects
Case Report
Differential diagnosis
Epstein-Barr virus
Histology
Internal medicine
Lungs
Lymph nodes
Lymphocytes
lymphoproliferative disorder
Methotrexate
Respiratory tract
Rheumatoid arthritis
wheezes
methotrexate
lymphoproliferative disorder
Epstein-Barr virus
wheezes
rheumatoid arthritis
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Summary:A 70-year-old woman was admitted for the evaluation of wheezes and a nodular lesion in the left lung field. She had been diagnosed with rheumatoid arthritis at 45 years of age and was continuously treated with methotrexate (MTX) at 8 mg/week. Bronchoscopic aspiration histology of a hilar lymph node suggested a lymphoproliferative disorder (LPD). After discontinuation of MTX, the lung nodule and wheezes disappeared. Although wheezes are not a usual manifestation of LPD, her clinical course clearly demonstrated an obvious relationship between LPD-induced airway narrowing and wheezes.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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Correspondence to Dr.　Shoki Miyoshi, shoki711@med.teikyo-u.ac.jp
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.2080-18