What question did this study set out to answer?

To illustrate a rare case of complete atelectasis associated with methotrexate-related lymphoproliferative disorder in a patient with rheumatoid arthritis.

March 29, 2026Open Access

Complete Atelectasis of Left Lung due to Methotrexate-associated Lymphoproliferative Disorder: A Case Report

HMHiroto MuraoAichi Medical University SOSaori OnishiAichi Medical University TYToshiyuki YonezawaAichi Medical University

Key Points

To illustrate a rare case of complete atelectasis associated with methotrexate-related lymphoproliferative disorder in a patient with rheumatoid arthritis.
Evaluation of a 59-year-old man experiencing dyspnea after methotrexate treatment.
Imaging via chest computed tomography to identify lung obstruction.
Histopathological analysis through trans-bronchial biopsies to confirm diagnosis.
Identification of a mass obstructing the left main bronchus leading to complete left lung atelectasis.
Positive results for Epstein-Barr virus during histopathological examination.
Remission of both tumor and atelectasis following withdrawal of methotrexate.

Abstract

A 59-year-old man who had been treated with methotrexate (MTX) for rheumatoid arthritis was referred to our hospital because of dyspnea. Chest computed tomography revealed a mass obstructing the left main bronchus and complete atelectasis of the left lung. Histopathology of the tumor obtained by trans-bronchial biopsies showed lymphoproliferative disorder (LPD) with positive results for Epstein-Barr virus-encoded small ribonucleic acid in situ hybridization. Withdrawal of MTX resulted in remission of both the tumor and atelectasis, supporting the diagnosis of MTX-associated LPD (MTX-LPD). We herein report a rare case of MTX-LPD with complete atelectasis of a unilateral lung.

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