Three different CT and FDG PET/CT findings of pulmonary involvement in methotrexate‐associated lymphoproliferative disease
Lymphoproliferative disease (LPD) is one of the complications of methotrexate (MTX) therapy. In MTX‐associated LPD (MTX‐LPD), LPD lesions limited to the lungs are rare and show various types of opacity. A 75‐year‐old woman with rheumatoid arthritis (RA) presented with myalgia. She had been taking MT...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-03-01
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| Series: | Respirology Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rcr2.520 |
| _version_ | 1818316204200165376 |
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| author | Sachi Matsubayashi Manabu Suzuki Keita Sakamoto Shinyu Izumi Masayuki Hojo Haruhito Sugiyama |
| author_facet | Sachi Matsubayashi Manabu Suzuki Keita Sakamoto Shinyu Izumi Masayuki Hojo Haruhito Sugiyama |
| author_sort | Sachi Matsubayashi |
| collection | DOAJ |
| description | Lymphoproliferative disease (LPD) is one of the complications of methotrexate (MTX) therapy. In MTX‐associated LPD (MTX‐LPD), LPD lesions limited to the lungs are rare and show various types of opacity. A 75‐year‐old woman with rheumatoid arthritis (RA) presented with myalgia. She had been taking MTX for 11 years. Chest computed tomography (CT) scans showed a nodule in the left lower lobe that had grown significantly and a new nodule in the right lower lobe. 18F‐fluorodeoxyglucose (FDG)/positron emission tomography (PET)/CT revealed significant FDG uptake in these nodules. Transbronchial biopsy specimen showed diffusely distributed CD20‐positive lymphoid cells, and we made a diagnosis of MTX‐LPD. All lung lesions disappeared within months after the immediate discontinuation of MTX. We also had two other patients with MTX‐LPD lung lesions that had high FDG uptake. FDG PET/CT might be a useful diagnostic tool as it may reflect disease progression and help identify separate lesions. |
| first_indexed | 2024-12-13T09:17:43Z |
| format | Article |
| id | doaj.art-071a79ee1d614d998254830951ca62af |
| institution | Directory Open Access Journal |
| issn | 2051-3380 |
| language | English |
| last_indexed | 2024-12-13T09:17:43Z |
| publishDate | 2020-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Respirology Case Reports |
| spelling | doaj.art-071a79ee1d614d998254830951ca62af2022-12-21T23:52:48ZengWileyRespirology Case Reports2051-33802020-03-0182n/an/a10.1002/rcr2.520Three different CT and FDG PET/CT findings of pulmonary involvement in methotrexate‐associated lymphoproliferative diseaseSachi Matsubayashi0Manabu Suzuki1Keita Sakamoto2Shinyu Izumi3Masayuki Hojo4Haruhito Sugiyama5Department of Respiratory Medicine National Center for Global Health and Medicine Tokyo JapanDepartment of Respiratory Medicine National Center for Global Health and Medicine Tokyo JapanDepartment of Respiratory Medicine National Center for Global Health and Medicine Tokyo JapanDepartment of Respiratory Medicine National Center for Global Health and Medicine Tokyo JapanDepartment of Respiratory Medicine National Center for Global Health and Medicine Tokyo JapanDepartment of Respiratory Medicine National Center for Global Health and Medicine Tokyo JapanLymphoproliferative disease (LPD) is one of the complications of methotrexate (MTX) therapy. In MTX‐associated LPD (MTX‐LPD), LPD lesions limited to the lungs are rare and show various types of opacity. A 75‐year‐old woman with rheumatoid arthritis (RA) presented with myalgia. She had been taking MTX for 11 years. Chest computed tomography (CT) scans showed a nodule in the left lower lobe that had grown significantly and a new nodule in the right lower lobe. 18F‐fluorodeoxyglucose (FDG)/positron emission tomography (PET)/CT revealed significant FDG uptake in these nodules. Transbronchial biopsy specimen showed diffusely distributed CD20‐positive lymphoid cells, and we made a diagnosis of MTX‐LPD. All lung lesions disappeared within months after the immediate discontinuation of MTX. We also had two other patients with MTX‐LPD lung lesions that had high FDG uptake. FDG PET/CT might be a useful diagnostic tool as it may reflect disease progression and help identify separate lesions.https://doi.org/10.1002/rcr2.520Diffuse large B‐cell lymphomaEpstein–Barr reactivation or Epstein–Barr infectionmethotrexatepsoriasisrheumatoid arthritis |
| spellingShingle | Sachi Matsubayashi Manabu Suzuki Keita Sakamoto Shinyu Izumi Masayuki Hojo Haruhito Sugiyama Three different CT and FDG PET/CT findings of pulmonary involvement in methotrexate‐associated lymphoproliferative disease Respirology Case Reports Diffuse large B‐cell lymphoma Epstein–Barr reactivation or Epstein–Barr infection methotrexate psoriasis rheumatoid arthritis |
| title | Three different CT and FDG PET/CT findings of pulmonary involvement in methotrexate‐associated lymphoproliferative disease |
| title_full | Three different CT and FDG PET/CT findings of pulmonary involvement in methotrexate‐associated lymphoproliferative disease |
| title_fullStr | Three different CT and FDG PET/CT findings of pulmonary involvement in methotrexate‐associated lymphoproliferative disease |
| title_full_unstemmed | Three different CT and FDG PET/CT findings of pulmonary involvement in methotrexate‐associated lymphoproliferative disease |
| title_short | Three different CT and FDG PET/CT findings of pulmonary involvement in methotrexate‐associated lymphoproliferative disease |
| title_sort | three different ct and fdg pet ct findings of pulmonary involvement in methotrexate associated lymphoproliferative disease |
| topic | Diffuse large B‐cell lymphoma Epstein–Barr reactivation or Epstein–Barr infection methotrexate psoriasis rheumatoid arthritis |
| url | https://doi.org/10.1002/rcr2.520 |
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