Methotrexate-related lymphomatoid granulomatosis: a case report of spontaneous regression of large tumours in multiple organs after cessation of methotrexate therapy in rheumatoid arthritis.
We describe a 54-year-old female patient with rheumatoid arthritis (RA) and Sjögren's syndrome (SS) who presented with right chest pain and a large mass visible in the upper right field of a chest X-ray. Computed tomography (CT) showed multiple tumours in both lungs, the liver, and the spleen. The right lung tumour was 8 cm in diameter with a cavity. Biopsy of the lung and liver revealed lymphomatoid granulomatosis (LG) and diffuse large B-cell lymphoma (DLBCL). These lesions spontaneously regressed after withdrawal of methotrexate without any therapy for the lymphoma. This is the first report of self-limiting LG in a patient, complicated with methotrexate-treated RA.
Shimada
K
K
Department of Rheumatology, Clinical Research Centre for Allergy and Rheumatology, National Hospital Organization, Sagamihara Hospital, 18-1 Sakuradai, Sagamihara, Kanagawa 228-8522, Japan. k-shimada@sagamihara-hosp.gr.jp
Matsui
T
T
Kawakami
M
M
Nakayama
H
H
Ozawa
Y
Y
Mitomi
H
H
Tohma
S
S
D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000139:chemically induced*; D008230:Lymphomatoid Granulomatosis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D008727:Methotrexate / Q000009:adverse effects*; D008875:Middle Aged; D011859:Radiography
D018501:Antirheumatic Agents; D008727:Methotrexate