Nagahiro Itaru, Miyamoto Manabu, Sugiyama Hironobu, Kawai Tsuyoshi, Toda Keisuke, Nobuhisa Tetsuharu, Endou Yoshikatsu, Watanabe Takanori, Matsumoto Yusuke, Watanabe Naoki, Kai Kyohei, Satou Shizou
Department of Surgery, Himeji Red Cross Hospital, Japan.
Gan To Kagaku Ryoho. 2011 Oct;38(10):1679-82.
A 68-year-old female received a left lower lobectomy for lung cancer (adenocarcinoma, pT2N1M0, stage II B). She had a postoperative bronchial fistula that was treated conservatively and cured. Two months after the operation, tegafur-uracil (UFT) 300 mg/day was initiated.She felt dyspnea on exertion after taking UFT for two weeks, and some infiltration shadows were observed on a chest X-ray two weeks later. A chest CT scan revealed unsegmental infiltration shadows at the intermediate areas of the right middle and lower lobes, and an air-bronchogram was observed inside of the shadows. A bronchoscopy was performed. Bronchoalveolar lavage revealed a high fraction rate of eosinophil(24%), and a transbronchial lung biopsy revealed infiltrations of lymphocytes, eosinophils and neutrophils into the intra-alveolar space. However, fibrosis of the alveolar wall was not observed. A drug-induced lymphocyte stimulation test was performed for UFT, resulting positive. She was diagnosed as drug-induced eosinopilic pneumonia due to UFT. After she discontinued UFT and started 30 mg/day of prednisolone, dyspnea and infiltrations on chest X-ray disappeared.
一名68岁女性因肺癌（腺癌，pT2N1M0，II B期）接受了左下肺叶切除术。她术后出现支气管瘘，经保守治疗后治愈。术后两个月，开始服用替加氟尿嘧啶（UFT），剂量为300毫克/天。服用UFT两周后，她感到活动时呼吸困难，两周后胸部X线检查发现一些浸润阴影。胸部CT扫描显示右中、下叶中间区域有非节段性浸润阴影，阴影内可见空气支气管造影征。进行了支气管镜检查。支气管肺泡灌洗显示嗜酸性粒细胞比例较高（24%），经支气管肺活检显示淋巴细胞、嗜酸性粒细胞和中性粒细胞浸润到肺泡腔内。然而，未观察到肺泡壁纤维化。对UFT进行了药物诱导淋巴细胞刺激试验，结果为阳性。她被诊断为UFT所致药物性嗜酸性粒细胞性肺炎。她停用UFT并开始服用泼尼松龙30毫克/天后，呼吸困难和胸部X线浸润影消失。
