Peer-reviewedCC BY-NC-NDInternal Medicine
Methotrexate-induced Other Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder with Diffuse Ground-glass Opacities Diagnosed Using a Cryobiopsy
Abstract
Methotrexate (MTX)-induced iatrogenic immunodeficiency-associated lymphoproliferative disorder (OIIA-LPD) usually presents as multiple pulmonary nodules or masses. However, we herein present a rare case demonstrating diffuse ground-glass opacities (GGOs). The patient was a 77-year-old woman with a history of rheumatoid arthritis and advanced gastric cancer. Because of the markedly elevated serum lactate dehydrogenase levels and diffuse GGOs on chest computed tomography, intravascular lymphoma was considered. A transbronchial lung cryobiopsy (TBLC) was performed to obtain tissue specimens for a histopathological evaluation, leading to a diffuse large B-cell lymphoma diagnosis after multidisciplinary discussions. To the best of our knowledge, this is the first report of MTX-induced OIIA-LPD diagnosed by TBLC.
Related
- P004 Progressive insufficiency fractures and structural foot collapse associated with methotrexate: a case report with evidence of re-challenge and de-challenge effect
- Rapidly progressive adult-onset hydroa vacciniforme-like lymphoproliferative disorder associated with Epstein-Barr virus: a case report.
- Sex- and age-stratified pharmacovigilance of methotrexate-associated adverse events in pediatric leukemia: a FAERS-based study
- An Active Cytomegalovirus Infection and Epstein-Barr Virus Reactivation Complicated by Cytomegalovirus Meningitis and Virus-Associated Hemophagocytic Lymphohistiocytosis during Methotrexate and Upadacitinib Therapy in a Patient with Rheumatoid Arthritis
- Epstein-Barr virus-associated T/NK-cell lymphoproliferative diseases with heterozygous IL10RA variants: two cases with pedigree analysis and a literature review.
BibTeX
@article{fujii2026methotrexateinduced,
title = {{Methotrexate-induced Other Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder with Diffuse Ground-glass Opacities Diagnosed Using a Cryobiopsy}},
author = {Tetsuya Fujii and Maki Asami-Noyama and Shuichiro Ohata and Keita Murakawa and Kazuki Hamada and Yoriyuki Murata and Keiji Oishi and Taiga Kobayashi and Yoshie Kunihiro and Tomoko Kondo-Furuya and Nobutaka Edakuni and Tomoyuki Kakugawa and Tsunahiko Hirano and Akira Hebisawa and Kazuto Matsunaga},
journal = {Internal Medicine},
year = {2026},
month = nov,
doi = {10.2169/internalmedicine.6755-25},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/21/65_6755-25/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Methotrexate-induced Other Iatrogenic Immunodeficiency-associated Lymphoproliferative Disorder with Diffuse Ground-glass Opacities Diagnosed Using a Cryobiopsy
AU - Tetsuya Fujii
AU - Maki Asami-Noyama
AU - Shuichiro Ohata
AU - Keita Murakawa
AU - Kazuki Hamada
AU - Yoriyuki Murata
AU - Keiji Oishi
AU - Taiga Kobayashi
AU - Yoshie Kunihiro
AU - Tomoko Kondo-Furuya
AU - Nobutaka Edakuni
AU - Tomoyuki Kakugawa
AU - Tsunahiko Hirano
AU - Akira Hebisawa
AU - Kazuto Matsunaga
PY - 2026
DA - 2026/11/01
JO - Internal Medicine
DO - 10.2169/internalmedicine.6755-25
UR - https://www.jstage.jst.go.jp/article/internalmedicine/65/21/65_6755-25/_article
AB - Methotrexate (MTX)-induced iatrogenic immunodeficiency-associated lymphoproliferative disorder (OIIA-LPD) usually presents as multiple pulmonary nodules or masses. However, we herein present a rare case demonstrating diffuse ground-glass opacities (GGOs). The patient was a 77-year-old woman with a history of rheumatoid arthritis and advanced gastric cancer. Because of the markedly elevated serum lactate dehydrogenase levels and diffuse GGOs on chest computed tomography, intravascular lymphoma was considered. A transbronchial lung cryobiopsy (TBLC) was performed to obtain tissue specimens for a histopathological evaluation, leading to a diffuse large B-cell lymphoma diagnosis after multidisciplinary discussions. To the best of our knowledge, this is the first report of MTX-induced OIIA-LPD diagnosed by TBLC.
SN - 1349-7235
SN - 0918-2918
ER -