Nakayasu Hiromasa, Shirai Toshihiro, Tanaka Yuko, Saigusa Mika
Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan.
Respir Med Case Rep. 2017 Aug 5;22:147-149. doi: 10.1016/j.rmcr.2017.08.001. eCollection 2017.
Reports of chronic eosinophilic pneumonia (CEP) after radiation therapy are limited to breast cancer. We herein describe a case of CEP after radiation therapy for lung cancer. The patient was a 65-year-old man who had asymptomatic peripheral blood eosinophilia but no history of asthma or allergy. One month after completion of radiation therapy, chest CT scan revealed infiltrates inside the irradiated area, leading to the diagnosis of radiation pneumonitis. His condition improved after receiving corticosteroids. However, one months after withdrawal of corticosteroids, he noticed cough and shortness of breath with patchy ground glass opacity in the contralateral lung. The WBC count was 9900/μl with 17% eosinophils and bronchoalveolar lavage showed eosinophils of 14%, leading to the diagnosis of CEP. His condition improved after receiving corticosteroids and subsequent tapering without recurrence. Asymptomatic peripheral blood eosinophilia at the initial diagnosis of lung cancer might be a trigger for developing CEP.
放射治疗后发生慢性嗜酸性粒细胞性肺炎（CEP）的报道仅限于乳腺癌。我们在此描述一例肺癌放射治疗后发生CEP的病例。患者为65岁男性，外周血嗜酸性粒细胞增多但无症状，无哮喘或过敏史。放射治疗结束1个月后，胸部CT扫描显示照射区域内有浸润影，诊断为放射性肺炎。接受糖皮质激素治疗后病情好转。然而，停用糖皮质激素1个月后，他出现咳嗽和气短，对侧肺出现斑片状磨玻璃影。白细胞计数为9900/μl，嗜酸性粒细胞占17%，支气管肺泡灌洗显示嗜酸性粒细胞占14%，诊断为CEP。接受糖皮质激素治疗并随后逐渐减量后病情好转，未复发。肺癌初诊时无症状的外周血嗜酸性粒细胞增多可能是发生CEP的触发因素。
