Upadya Anupama, Amoateng-Adjepong Yaw, Haddad Raymond G
Department of Internal Medicine, Pulmonary Division, Yale University School of Medicine, New Haven, CT, USA.
South Med J. 2003 Aug;96(8):821-3. doi: 10.1097/01.SMJ.0000047624.10190.3D.
We present the case of a 63-year-old woman with metastatic, high-grade pleomorphic sarcoma who had recurrent, bilateral pneumothorax while on a regimen of doxorubicin and dacarbazine. We postulate that her doxorubicin-based chemotherapy induced rapid cell lysis and necrosis of peripherally located, metastatic pulmonary nodules, leading to the pneumothoraces. Other potential mechanisms include bronchopleural fistula, rupture of dilated alveoli distal to a stenosis, chemotherapy-induced impairment of repair processes, and persistent local infection. Pneumothoraces related to pulmonary metastases tend to be refractory to conventional therapy and necessitate surgical intervention to prevent recurrences.
我们报告了一例63岁患有转移性高级别多形性肉瘤的女性病例，该患者在接受阿霉素和达卡巴嗪治疗期间反复出现双侧气胸。我们推测，她基于阿霉素的化疗导致外周转移性肺结节快速细胞溶解和坏死，从而引发气胸。其他潜在机制包括支气管胸膜瘘、狭窄远端扩张肺泡破裂、化疗引起的修复过程受损以及持续局部感染。与肺转移相关的气胸往往对传统治疗无效，需要手术干预以防止复发。
