【乳腺癌术后放疗后组织肺炎的发生】。

Takayuki Kishikawa, Hiroko Imadachi, Katsuji Hirano, Shota Nakashima, Eisuke Sasaki, Akitoshi Kinoshita
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引用次数: 0

摘要

本文报道三例乳腺癌术后放射治疗后发生的组织性肺炎(OP)。所有患者术后均接受切向放疗和他莫昔芬(TAM)辅助治疗。2例出现发热和咳嗽;一个是无症状的。胸部x线摄影和计算机断层扫描显示放射场外周围肺泡混浊。支气管肺泡灌洗显示总细胞计数升高,淋巴细胞比例高,两例嗜酸性粒细胞水平升高。经支气管肺活检显示与组织性肺炎一致的组织学模式。对于两例有症状的病例,皮质类固醇治疗可迅速减轻临床症状并改善影像学表现。单例无症状患者经治疗后病情好转。近年来,此类病例的报告数量有所增加,但病因尚不清楚。在这三个病例中,TAM联合放射治疗可能是OP的原因。
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[Occurrence of organizing pneumonia after radiation therapy for postoperative breast cancer].

Three cases of organizing pneumonia (OP) that occurred after planned radiation therapy for postoperative breast cancer are reported. All patients received tangential radiation therapy and adjuvant tamoxifen (TAM) for postoperative breast cancer. Two patients developed fever and cough; one was asymptomatic. Chest radiography and computed tomography demonstrated peripheral alveolar opacities outside the radiation field. Bronchoalveolar lavage showed an elevated total cell count with a high percentage of lymphocytes, as well as elevated eosinophil levels in two cases. Transbronchial lung biopsy revealed a histologic pattern consistent with organizing pneumonia. For the two symptomatic cases, treatment with corticosteroids reduced clinical symptoms promptly and improved imaging findings. The single asymptomatic case improved without treatment. The number of such reported cases has increased in recent years, but the etiology is unclear. In the three cases presented, TAM combined with radiation therapy may have been the cause of the OP.

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