Guerriero Gabriella, Battista Cleonice, Montesano Marilena, Carino Rita, Primavera Angelo, Costantino Sebastiano, Spoto Silvia, D'Angelillo Rolando Maria, Altomare Vittorio
Surgical Science Department, Policlinico Umberto I, La Sapienza University, Rome, Italy.
Tumori. 2005 Sep-Oct;91(5):421-3. doi: 10.1177/030089160509100508.
Breast-conserving surgery and postoperative radiotherapy play an important role in the treatment of early breast cancer. Bronchiolitis obliterans with organizing pneumonia (BOOP) is an uncommon syndrome reported to be one of the complications of adjuvant radiotherapy. We report the case of a 71-year-old woman who developed cough, dyspnea and fever three weeks after radiation therapy to the left breast for breast carcinoma. Chest X-ray and computed tomography scan demonstrated alveolar opacities within both lungs. Antibiotic therapy against any probable septic pathology did not improve the symptoms, while corticosteroid treatment resulted in rapid clinical improvement together with regression of the pulmonary opacities. Irradiation was thought to be the cause of the migratory pneumonitis, hence this case was clinically diagnosed as radiation-induced migratory pneumonitis similar to BOOP, without lung biopsy. The present case suggests that one should be mindful of this disease when treating patients with a history of irradiation to the breast. BOOP promptly responds to systemic corticosteroid therapy with rapid improvement of symptoms and regression of the pulmonary opacities.
保乳手术和术后放疗在早期乳腺癌治疗中发挥着重要作用。闭塞性细支气管炎伴机化性肺炎（BOOP）是一种罕见综合征，据报道是辅助放疗的并发症之一。我们报告了一例71岁女性病例，该患者在左侧乳腺癌放疗三周后出现咳嗽、呼吸困难和发热。胸部X线和计算机断层扫描显示双肺出现肺泡性混浊。针对任何可能的脓毒症病理进行的抗生素治疗均未改善症状，而皮质类固醇治疗使临床症状迅速改善，同时肺部混浊消退。推测放疗是迁徙性肺炎的病因，因此该病例在未进行肺活检的情况下临床诊断为类似于BOOP的放射性迁徙性肺炎。本病例提示，在治疗有乳房放疗史的患者时应留意这种疾病。BOOP对全身皮质类固醇治疗反应迅速，症状迅速改善，肺部混浊消退。
