Ujino Mariko, Miyoshi Shoki, Sugimoto Naoya, Arai Hidenori, Ota Yasunori, Sasajima Yuko, Kawamura Masafumi, Nagase Hiroyuki, Yamaguchi Masao, Ohta Ken
Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Japan.
Department of Pathology, Teikyo University School of Medicine, Japan.
Intern Med. 2019 Jun 15;58(12):1759-1764. doi: 10.2169/internalmedicine.2080-18. Epub 2019 Feb 1.
A 70-year-old woman was admitted for the evaluation of wheezes and a nodular lesion in the left lung field. She had been diagnosed with rheumatoid arthritis at 45 years of age and was continuously treated with methotrexate (MTX) at 8 mg/week. Bronchoscopic aspiration histology of a hilar lymph node suggested a lymphoproliferative disorder (LPD). After discontinuation of MTX, the lung nodule and wheezes disappeared. Although wheezes are not a usual manifestation of LPD, her clinical course clearly demonstrated an obvious relationship between LPD-induced airway narrowing and wheezes.
一名70岁女性因左肺野哮鸣音和结节性病变入院评估。她45岁时被诊断为类风湿关节炎，一直以每周8毫克的甲氨蝶呤（MTX）进行治疗。肺门淋巴结的支气管镜下吸取组织学检查提示为淋巴增殖性疾病（LPD）。停用MTX后，肺部结节和哮鸣音消失。虽然哮鸣音并非LPD的常见表现，但她的临床病程清楚地显示出LPD引起的气道狭窄与哮鸣音之间存在明显关联。
