Tomoyuki Fujisawa, Shinobu Hatakeyama, Akio Tachibana, Kazue Suzuki, Teruaki Oka, Takahumi Suda, Kingo Chida, Hirotoshi Nakamura
Department of Respiratory Medicine, Yaizu Municipal Hospital, 1000 Doubara, Yaizu, Shizuoka, 425-0055, Japan.
Nihon Kokyuki Gakkai Zasshi. 2002 Aug;40(8):660-5.
A 54-year-old woman underwent conserving surgery for right breast cancer, and received a cumulative dose of 50 Gy of radiation therapy to the remaining part of the right breast. About five months after the termination of irradiation, cough and low-grade fever developed. The chest radiograph showed an infiltrative shadow in the right lung field. Organizing pneumonia was identified in the transbronchial lung biopsy specimen. After prednisolone was given to the patient the clinical symptoms and infiltrates seen in the radiograph disappeared. In the course of tapering the prednisolone dose, new infiltrative shadows developed in the upper right lung and the left lung. The histologic changes were shown by transbronchial lung biopsy to be organizing pneumonia. The increased dose of prednisolone resulted in the rapid improvement of the clinical symptoms and chest radiograph abnormalities. This case suggests that breast radiation after conserving surgery for breast cancer may cause a pathologic process similar to that of bronchiolitis obliterans organizing pneumonia.
一名54岁女性接受了右乳腺癌保乳手术，并对右乳剩余部分接受了累积剂量为50 Gy的放射治疗。放疗结束约五个月后，出现咳嗽和低热。胸部X线片显示右肺野有浸润性阴影。经支气管肺活检标本中发现机化性肺炎。给予患者泼尼松龙后，临床症状及X线片上所见的浸润影消失。在逐渐减少泼尼松龙剂量的过程中，右上肺和左肺出现了新的浸润性阴影。经支气管肺活检显示组织学改变为机化性肺炎。泼尼松龙剂量增加导致临床症状和胸部X线片异常迅速改善。该病例提示，乳腺癌保乳手术后的乳房放疗可能会引发一种与闭塞性细支气管炎伴机化性肺炎相似的病理过程。
