Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Immunotherapy. 2020 Apr;12(5):293-298. doi: 10.2217/imt-2019-0122. Epub 2020 Apr 15.
The use of immune checkpoint inhibitors is associated with significant toxicities such as pneumonitis; the clinical presentation of the latter can be misleading and may mimic metastasis. We report the case of a melanoma patient who developed late-onset pneumonitis after discontinuation of treatment with anti-programmed cell death protein 1 (PD1) and anti-cytotoxic T lymphocyte antigen 4 (CTLA4) (patient had a complete response). The patient was asymptomatic, however, surveillance computed tomography (CT) scan showed a growing lung nodule and several new-onset, small lung lesions highly suspicious for recurrence. A biopsy of the lesions revealed organizing pneumonia with absence of malignant cells. The lung lesions completely resolved after 6 months without any intervention. The patient is still in complete remission 2 years after the initial diagnosis of melanoma.
免疫检查点抑制剂的使用与显著的毒性相关，例如肺炎；后者的临床表现可能具有误导性，并可能类似于转移。我们报告了一例黑色素瘤患者，在停止使用抗程序性细胞死亡蛋白 1（PD1）和抗细胞毒性 T 淋巴细胞抗原 4（CTLA4）治疗后出现迟发性肺炎（患者有完全缓解）。然而，该患者无症状，但是，监测计算机断层扫描（CT）显示肺结节增大，并出现数个新的、疑似复发的小肺病变。病变活检显示为机化性肺炎，无恶性细胞。在没有任何干预的情况下，肺部病变在 6 个月后完全消退。在最初诊断为黑色素瘤后 2 年，患者仍处于完全缓解状态。
