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

Hideaki YamakawaDepartment of Respiratory Medicine, Jikei University School of Medicine, Kashiwa Hospital, Chiba, JapanCorrespondence[email protected]

Masahiro YoshidaDepartment of Respiratory Medicine, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan

Hiroaki KatagiDepartment of Diagnostic Pathology, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan

Shinichi HirookaDepartment of Diagnostic Pathology, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan

Keitaro OkudaDepartment of Respiratory Medicine, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan

Takeo IshikawaDepartment of Respiratory Medicine, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan

Masamichi TakagiDepartment of Respiratory Medicine, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan

Kazuyoshi KuwanoDivision of Respiratory Diseases, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan

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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.

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

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

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