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Vol.53 No.3 contents

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- Case Report -

A Case of Methotrexate-associated Lymphomatoid Granulomatosis

Tomoyuki Ogata¹, Shou Shibata¹, Eisuke Matsuoka¹, Takashi Nakayama², Junji Yoshida², Kouji Unoura^1
1Department of Respiratory Medicine, JA Toride Medical Center, Japan, ²Department of Thoracic Oncology, National Cancer Center Hospital East, Japan

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Background. Methotrexate, a folate metabolism antagonist, is a first-line drug for rheumatoid arthritis, which can induce lymphoproliferative disorders. Case. A 73-year-old female had been treated with methotrexate for rheumatoid arthritis for 14 months. A chest CT scan showed multiple pulmonary nodules bilaterally. A transbronchial biopsy, CT-guided percutaneous lung biopsy and ultrasonography-guided liver biopsy did not lead to a diagnosis; therefore, partial resection of the lung was performed under video-assisted thoracoscopic surgery. The histopathology revealed lymphomatoid granulomatosis (grade 2), and the abnormal shadows were immediately reduced by methotrexate withdrawal. Conclusion. We herein reported a rare case of methotrexate-associated lymphomatoid granulomatosis.
key words: Methotrexate, Methotrexate-associated lymphoproliferative disorders, Lymphomatoid granulomatosis

Received: April 9, 2013
Accepted: May 14, 2013

JJLC 53 (3): 234-239, 2013