鳞状细胞肺癌放疗后致慢性嗜酸粒细胞肺炎
2017/10/23
摘要
辐射治疗后慢性嗜酸性粒细胞肺炎（CEP）的报道仅限于乳腺癌。本文描述了放射治疗肺癌后CEP的病例。病人是一名65岁的男子,出现无症状的外周血嗜酸性粒细胞增多，但没有哮喘或过敏史。放射治疗完成一个月后，胸部CT扫描显示在照射区域内有浸润表现，导致放射性肺炎的诊断。接受皮质类固醇后，他的状况有所改善。然而，在皮质类固醇戒除一个月后，他出现咳嗽和呼吸急促的症状及对侧肺中出现斑块状磨玻璃影。 WBC计数为9900 / ml，嗜酸性粒细胞为17％，支气管肺泡灌洗显示嗜酸性粒细胞为14％，导致CEP的诊断。接受皮质类固醇后其症状改善，随访过程中无复发。肺癌的初步诊断中无症状的外周血嗜酸粒细胞增多可能是CEP的触发因素。
Chronic eosinophilic pneumonia after radiation therapy for squamous cell lung cancer
Nakayasu H, Shirai T, Tanaka Y, et al.
Hiromasa Nakayasu, Toshihiro Shirai*, Yuko Tanaka, Mika Saigusa
Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
abstract
Reports of chronic eosinophilic pneumonia (CEP) after radiation therapy are limited to breast cancer. We herein describe a case of CEP after radiation therapy for lung cancer. The patient was a 65-year-old man who had asymptomatic peripheral blood eosinophilia but no history of asthma or allergy. One month after completion of radiation therapy, chest CT scan revealed infiltrates inside the irradiated area, leading
to the diagnosis of radiation pneumonitis. His condition improved after receiving corticosteroids. However, one months after withdrawal of corticosteroids, he noticed cough and shortness of breath with patchy ground glass opacity in the contralateral lung. The WBC count was 9900/ml with 17% eosinophils and bronchoalveolar lavage showed eosinophils of 14%, leading to the diagnosis of CEP. His condition improved after receiving corticosteroids and subsequent tapering without recurrence Asymptomatic peripheral blood eosinophilia at the initial diagnosis of lung cancer might be a trigger for developing CEP.
辐射治疗后慢性嗜酸性粒细胞肺炎（CEP）的报道仅限于乳腺癌。本文描述了放射治疗肺癌后CEP的病例。病人是一名65岁的男子,出现无症状的外周血嗜酸性粒细胞增多，但没有哮喘或过敏史。放射治疗完成一个月后，胸部CT扫描显示在照射区域内有浸润表现，导致放射性肺炎的诊断。接受皮质类固醇后，他的状况有所改善。然而，在皮质类固醇戒除一个月后，他出现咳嗽和呼吸急促的症状及对侧肺中出现斑块状磨玻璃影。 WBC计数为9900 / ml，嗜酸性粒细胞为17％，支气管肺泡灌洗显示嗜酸性粒细胞为14％，导致CEP的诊断。接受皮质类固醇后其症状改善，随访过程中无复发。肺癌的初步诊断中无症状的外周血嗜酸粒细胞增多可能是CEP的触发因素。
（中日友好医院呼吸与危重症医学科 张鑫 摘译 林江涛 审校）
（Chronic eosinophilic pneumonia after radiation therapy for squamous cell lung cancer[J]. Respiratory Medicine Case Reports, 2017, 22:147-149.）
（Chronic eosinophilic pneumonia after radiation therapy for squamous cell lung cancer[J]. Respiratory Medicine Case Reports, 2017, 22:147-149.）
Chronic eosinophilic pneumonia after radiation therapy for squamous cell lung cancer
Nakayasu H, Shirai T, Tanaka Y, et al.
Hiromasa Nakayasu, Toshihiro Shirai*, Yuko Tanaka, Mika Saigusa
Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
abstract
Reports of chronic eosinophilic pneumonia (CEP) after radiation therapy are limited to breast cancer. We herein describe a case of CEP after radiation therapy for lung cancer. The patient was a 65-year-old man who had asymptomatic peripheral blood eosinophilia but no history of asthma or allergy. One month after completion of radiation therapy, chest CT scan revealed infiltrates inside the irradiated area, leading
to the diagnosis of radiation pneumonitis. His condition improved after receiving corticosteroids. However, one months after withdrawal of corticosteroids, he noticed cough and shortness of breath with patchy ground glass opacity in the contralateral lung. The WBC count was 9900/ml with 17% eosinophils and bronchoalveolar lavage showed eosinophils of 14%, leading to the diagnosis of CEP. His condition improved after receiving corticosteroids and subsequent tapering without recurrence Asymptomatic peripheral blood eosinophilia at the initial diagnosis of lung cancer might be a trigger for developing CEP.
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