The Journal of the Japanese Respiratory Society ONLINE JOURNAL
ABSTRACT
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Article in Japanese
Case Report
A case of imatinib mesylate-induced pneumonitis based on the detection of epithelioid granulomas by video-assisted thoracoscopic surgery biopsy in a patient with chronic myeloid leukemia
Takashi Koide1), Takeshi Saraya1), Keitaro Nakamoto1), Akira Nakajima1), Haruyuki Ishii1), Masachika Fujiwara2), Hidekatsu Shibata3), Teruaki Oka4), Tomoyuki Goya3) and Hajime Goto1)
1)Department of Respiratory Medicine, Kyorin University Hospital
2)Department of Pathology, Kyorin University Hospital
3)Department of General Thoracic Surgery, Kyorin University Hospital
4)Department of Pathology, The Mutual Aid Association of School Teachers, Kanto Central Hospital
ABSTRACT
A 79-year-old man with chronic myeloid leukemia was referred to our department because of dry cough and low-grade fever, 272 days after commencing imatinib mesylate (Gleevec®). High resolution computed tomography (HRCT) showed tiny scattered centrilobular nodules and ground-glass opacities throughout both lung fields, suggesting drug-induced pneumonitis. A thoracic video-assisted thoracoscopic surgery (VATS) biopsy specimen from the centrilobular nodules in the right upper lobe demonstrated patchy distribution of epithelioid cell granulomas and intra-alveolar organization. Most of those lesions were predominantly located in the alveolar spaces, which implicated non-transbronchial distribution. Following drug cessation alone, the patient's general condition and radiological abnormalities improved.
KEYWORDS: Imatinib mesylate, Video-assisted thoracoscopic surgery, Drug-induced pneumonitis, Epithelioid granuloma
RECEIVED: 2010.12.9
JJRS, 49(6): 465-471, 2011
