ABSTRACT
A 67-year-old woman with rheumatoid arthritis was hospitalized because of dysphagia and severe nodulosis. Over a two-year period the patient had been treated with methotrexate. A computed tomography (CT) scan of the neck showed a 2 x 2 cm large tumour behind the top left lateral thyroid cartilage. A biopsy taken during direct laryngoscopy showed it was a rheumatic nodule. Treatment with colchicine reduced the patient's dysphagia. As methotrexate is used increasingly in the treatment of rheumatoid arthritis and as this particular drug causes rheumatic nodules in five to 10 per cent of the patients, it must be foreseen that the incidence of nodules in the upper airways will increase.
Subject(s)
Antirheumatic Agents/adverse effects , Laryngeal Diseases/chemically induced , Methotrexate/adverse effects , Rheumatic Nodule/chemically induced , Aged , Colchicine/therapeutic use , Female , Gout Suppressants/therapeutic use , Humans , Laryngeal Diseases/diagnostic imaging , Laryngeal Diseases/drug therapy , Laryngoscopy , Rheumatic Nodule/diagnostic imaging , Rheumatic Nodule/drug therapy , Tomography, X-Ray ComputedABSTRACT
The case describes a seven year-old Danish boy who was referred with a short history of nasal obstruction and enlargement of the lymph nodes on the left side of the neck. The ENT examination demonstrated a large parapharyngeal tumour, which was shown by CT-scanning to extend from the level of the zygomatic arch to the superior thoracic aperture. The histological diagnosis was a Burkitt's lymphoma.
