May 2013 pulmonary case of the month: the cure can be worse than the disease

• Main Authors: Wesselius LJ, Colby TV
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2013-05-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: dermatomyositis; methotrexate; lymphoma; Epstein-Barr virus; Reed-Sternberg cells; lymphoproliferative disease; immunodeficiency-related lymphoproliferative disease; methotrexate-associated lymphoproliferative disease
• Online Access: http://www.swjpcc.com/pulmonary/2013/5/1/may-2013-pulmonary-case-of-the-month-the-cure-can-be-worse-t.html

No abstract available. Article truncated after 150 words. History of Present Illness A 65 year old man from Colorado presented for evaluation of “lung masses.” He had a prior diagnosis of dermatomyositis made in 2010 and had been with intravenous immunoglobulin (IVIG), prednisone and methotrexate. He had been previously seen in January, 2011 with a 5 mm left lower lobe nodule on thoracic CT which was unchanged compared to August, 2010. A thoracic CT scan done in July, 2011 in Colorado was interpreted as stable. Over the prior month had been having chest discomfort. He had a history of pulmonary embolism (PE) and felt the pain was similar in quality to his prior PE. This prompted a chest x-ray and he was told of “lung masses”. He had also experienced 20 pound weight loss. His current medications included methotrexate 25 mg weekly, prednisone 3 mg every other day and warfarin 7 mg daily. PMH, SH, FH In addition …