PMC6546950_01
Image of squamous cell carcinoma in the left upper bronchus.. [a] Bronchoscope showing tumor protrusion at the orifice of the left B1 + 2.. [b] Positron emission tomography/computed tomography (PET/CT) showing high accumulation in the left B1 + 2.
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A 72-year-old man was referred to our hospital for treatment of lung cancer in the left upper bronchus (Fig. 1a). Fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) revealed that FDG uptake in the tumor occurred only in the bronchus (Fig. 1b).
Image of the lymphoproliferative disorder in the right upper lobe.. [a] Chest computed tomography 2 weeks after first surgery showing a 1-cm-sized pulmonary nodule in the contralateral lung.. [b] Histopathological examination showing spindle cells with karyokinesis. Immunohistochemical staining showed that the cells were positive for CD20; a diagnosis of B-cell lymphoma-type lymphoproliferative disorder was made.
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However, chest CT performed 1 week before surgery revealed a 1-cm-sized pulmonary nodule in the contralateral lung (Fig. 2a). The pathological diagnosis of the right pulmonary nodule was a diffuse, large B-cell lymphoma (DLBCL), which is associated with a history of long-term oral MTX administration, and was considered a MTX-LPD-related lung lesion (Fig. 2b).
MTX-associated lymphoproliferative disorder in the left lower lobe.. [a] Chest computed tomography (CT) at 2 weeks after the first surgery showing a new 1-cm-sized nodule in the left lower lobe.. [b] Chest CT at 1 month after the second surgery showing that the nodules in the left lower lobe have disappeared.
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Chest CT performed 2 weeks after the first surgery revealed a new 1-cm-sized nodule on the lower left lung lobe (Fig. 3a). Chest CT performed 1 month after the surgery revealed that the nodules in the left lower lobe disappeared; therefore, the lesion was assumed to have disappeared at the time of the second surgery (Fig. 3b).