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.
|Number of pages||6|
|Journal||Nishinihon Journal of Urology|
|Publication status||Published - Dec 1 2018|
- Hodgkin's lymphoma
- Methotrexate-associated lymphoproliferative disorders
- Rheumatoid arthritis
ASJC Scopus subject areas