• Internal medicine · Feb 2020

    Pulmonary Intravascular Large B-cell Lymphoma in a Patient Administered Methotrexate for Rheumatoid Arthritis.

    • Eri Iwami, Fumimaro Ito, Kotaro Sasahara, Aoi Kuroda, Tatsu Matsuzaki, Takahiro Nakajima, Daichi Abe, Kimihiro Matsumoto, Aya Sasaki, Keisuke Eguchi, and Takeshi Terashima.
    • Department of Respiratory Medicine, Tokyo Dental College Ichikawa General Hospital, Japan.
    • Intern. Med. 2020 Feb 1; 59 (3): 429-433.

    AbstractA 70-year-old woman with rheumatoid arthritis undergoing methotrexate (MTX) treatment presented with dyspnea and a subfever. Computed tomography (CT) revealed a diffuse minimal ground-glass appearance in both lungs and splenomegaly. The gallium scintigram showed a diffuse, mild uptake in both lungs and the spleen. The lung biopsy specimen revealed the presence of CD20-positive atypical lymphocytes in the small pulmonary vessels. The patient was diagnosed with pulmonary intravascular diffuse large B-cell lymphoma (IVLBCL) and exhibited spontaneous regression after MTX was discontinued. This report describes a rare case of MTX-associated lymphoproliferative disorder expressing pulmonary IVLBCL.

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