Ishimatsu Y, Iwashita T, Kaida H, Shikuwa C, Matsubara Y, Yoshinaga M, Kadota J, Kohno S
Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Nihon Kokyuki Gakkai Zasshi. 2000 Aug;38(8):610-4.
We report a case of sputum and dyspnea with patchy migratory air space infiltrates that developed in a 49-year old woman after she started breast radiation therapy following surgery for breast carcinoma. Our case clearly differed from ordinary radiation pneumonitis. Chest roentogenography and computed tomographic (CT) scanning demonstrated alveolar opacities. Bronchoalveolar lavage showed a moderate elevation of the total cell concentration and a considerable increase of lymphocytes, and transbronchial lung biopsies revealed a histological pattern of bronchiolitis obliterans organizing pneumonia with intra-alveolar granulation tissue. The present case suggests that breast irradiation may contribute to the development of a histological pattern of bronchiolitis obliterans organizing pneumonia.
我们报告一例49岁女性在乳腺癌手术后开始接受乳房放射治疗后出现痰液和呼吸困难,并伴有斑片状游走性肺实质浸润。我们的病例明显不同于普通放射性肺炎。胸部X线摄影和计算机断层扫描(CT)显示肺泡混浊。支气管肺泡灌洗显示总细胞浓度中度升高,淋巴细胞显著增加,经支气管肺活检显示闭塞性细支气管炎伴机化性肺炎的组织学模式及肺泡内肉芽组织。本病例提示乳房照射可能促使闭塞性细支气管炎伴机化性肺炎组织学模式的发生。