Urethral tumor induced by methotrexate-associated lymphoproliferative disorders: A case report

Kasumi Kawamura, Yuki Maruyama, Takuya Sadahira, Yosuke Mitsui, Shingo Nishimura, Atsushi Takamoto, Seiji Kai, Koichiro Wada, Ryuta Tanimoto, Morito Sugimoto, Yasuyuki Kobayashi, Motoo Araki, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu, Takehiro Tanaka

Research output: Contribution to journalArticle

Abstract

A 64-year-old woman who had recurrent fever was referred to our hospital. She had been diagnosed with rheumatoid arthritis (RA) in 2007 and treated with methotrexate (MTX) therapy since 2008. She had the same symptoms in 2015. At that time, Cervical cancer and lung metastasis were suspected from computed tomography (CT) scan. Cervical punch biopsy revealed no malignancy. The lung nodules and her symptoms disappeared on spontaneous regression. CT scan showed left pyelectasis, left ureteral stenosis, urethral tumor and various parts of lymphadenopathy. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) showed an uptake of FDG in the left renal hilar lymph node, the urethra and the nasopharynx. MTX-associated lymphoproliferative disorders (MTX-LPD) were suspected rather than metastatic urothelial carcinoma. Pathological examination of the nasopharynx biopsy showed Hodgkin's lymphoma, and Epstein-Barr-encoding region in situ hybridization (EBER-ISH) stain was positive. MTX-LPD was diagnosed. One year after MTX withdrawal, tumors of the left ureter and the urethra remain, but other lesions have shown regression in size.

Original languageEnglish
Pages (from-to)678-683
Number of pages6
JournalNishinihon Journal of Urology
Volume80
Issue number12
Publication statusPublished - Dec 1 2018

Keywords

  • Hodgkin's lymphoma
  • Methotrexate
  • Methotrexate-associated lymphoproliferative disorders
  • Rheumatoid arthritis
  • Urethra

ASJC Scopus subject areas

  • Urology

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