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[非小细胞肺癌患者化疗期间发生空洞的肺非结核分枝杆菌病(胞内分枝杆菌)]

[Pulmonary non-tuberculous mycobacteriosis (Mycobacterium intracellulare) with cavities developing in a non-small cell lung cancer patient during chemotherapy].

作者信息

Matsumoto Aki, Enomoto Tatsuji, Muroya Youhei, Sugisaki Midori, Shingu Akiko, Saitoh Hitoshi, Nomura Kouichiro

机构信息

Department of Respiratory Medicine, Tokyo Metropolitan Hiroo Hospital.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2010 Aug;48(8):609-13.

Abstract

A 70-year-old man was admitted to our hospital for examination of an abnormal shadow found on a chest radiograph. Chest CT showed a nodular shadow in the left upper lobe S1+2. We diagnosed non-small cell lung cancer (squamous cell carcinoma) clinical stage T4N2M1. Chemotherapy consisting of carboplatin and weekly paclitaxel was begun. After the second course of chemotherapy, another nodular shadow with small cavities in the left lower lobe S6 was seen, and which then increased in size. Bronchial lavage revealed a diagnosis of non-tubercular mycobacteriosis (Mycobacterium intracellulare). Anti-NTM chemotherapy consisting of rifampicin, ethambutol and clarithromycin was started in addition to anticancer chemotherapy, without severe side effects. Although there are some reports of the co-occurrence of lung cancer and non-tuberculous mycobacteriosis, this apparently rare case involved the appearance of a solitary nodule with a cavity caused by pulmonary non-tuberculous mycobacteriosis during anticancer chemotherapy.

摘要

一名70岁男性因胸部X线片发现异常阴影入院检查。胸部CT显示左上叶S1+2有一个结节状阴影。我们诊断为非小细胞肺癌(鳞状细胞癌),临床分期为T4N2M1。开始使用卡铂和每周一次的紫杉醇进行化疗。在第二个化疗疗程后,左下叶S6出现了另一个有小空洞的结节状阴影,随后其大小增加。支气管灌洗显示诊断为非结核分枝杆菌病(胞内分枝杆菌)。除抗癌化疗外,开始使用由利福平、乙胺丁醇和克拉霉素组成的抗非结核分枝杆菌化疗,未出现严重副作用。虽然有一些关于肺癌和非结核分枝杆菌病同时发生的报道,但这个明显罕见的病例涉及在抗癌化疗期间出现由肺部非结核分枝杆菌病引起的有空洞的孤立结节。

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