Himeji Daisuke, Tanaka Gen-Ichi, Fukuyama Chikara, Yamanaka Atsushi, Shiiba Ritsuya, Moriguchi Sayaka, Marutsuka Kousuke
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, 5-30 Kitatakamatsu-cho, Miyazaki-shi, Miyazaki, 880-8510, Japan.
Department of Anatomic Pathology, Miyazaki Prefectural Miyazaki, Hospital, 5-30 Kitatakamatsu-cho, Miyazaki-shi, Miyazaki, 880-8510, Japan.
Respir Med Case Rep. 2019 Aug 12;28:100923. doi: 10.1016/j.rmcr.2019.100923. eCollection 2019.
A 70-year-old woman diagnosed with advanced, non-resectable programmed cell death ligand 1-positive-non-small-cell lung carcinoma was treated with pembrolizumab as first-line therapy. Soon after therapy initiation, she presented with severe dyspnea, and chest computed tomography revealed a soft tissue mass in the lower trachea of the right main bronchus. During bronchoscopy, she became severely hypoxic, and we performed endoscopic tumor ablation and Dumon Y-stent placement. We considered this severe deterioration caused by pseudoprogression, and suggest that it is necessary to perform bronchoscopy and to prepare for the bronchial intervention when treating patients with immune checkpoint inhibitors.
一名70岁女性被诊断为晚期、不可切除的程序性细胞死亡配体1阳性非小细胞肺癌,接受帕博利珠单抗作为一线治疗。治疗开始后不久,她出现严重呼吸困难,胸部计算机断层扫描显示右主支气管下气管有一个软组织肿块。在支气管镜检查期间,她出现严重缺氧,我们进行了内镜肿瘤消融和Dumon Y型支架置入。我们认为这种严重恶化是由假性进展引起的,并建议在使用免疫检查点抑制剂治疗患者时,有必要进行支气管镜检查并做好支气管介入准备。