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Modern Rheumatology Volume 26, 2016 - Issue 3
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Case Report

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
 show all
Pages 441-444 | Received 17 Jan 2014, Accepted 25 Feb 2014, Published online: 01 Apr 2014
 
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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.

Conflict of interest

None.

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