Esperança-Martins Miguel, Evangelista Vasco, Fernandes Salomão, Almeida Raquel
Medical Oncology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.
Sérgio Dias/Vascular Biology and Cancer Microenvironment Lab, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal.
Case Rep Oncol. 2021 Mar 22;14(1):550-560. doi: 10.1159/000514729. eCollection 2021 Jan-Apr.
Diffuse alveolar haemorrhage related to an anti-neutrophil cytoplasmic antibody (ANCA)-associated small vessel vasculitis is an extremely rare form of presentation of breast cancer. Here we report the case of a 77-year-old woman with a histological diagnosis of a papillary ductal carcinoma of the breast presenting with a diffuse alveolar haemorrhage secondary to a perinuclear ANCA-associated vasculitis. To our knowledge, this is the first case ever reported of a diffuse alveolar haemorrhage related to an ANCA-associated small vessel vasculitis as a form of presentation of breast cancer. The therapeutic approach of this paraneoplastic vasculitis included the use of corticosteroids and plasmapheresis, a very useful technique to remove endothelial aggressors (circulating antibodies) as a strategy to earn time for a proper therapeutic decision specifically directed for disease modification, but that can also be associated with several severe adverse effects, which are illustrated in our case.
与抗中性粒细胞胞浆抗体（ANCA）相关的小血管炎相关的弥漫性肺泡出血是乳腺癌一种极其罕见的表现形式。在此，我们报告一例77岁女性，其组织学诊断为乳腺导管乳头状癌，表现为继发于核周ANCA相关血管炎的弥漫性肺泡出血。据我们所知，这是首例报告的与ANCA相关小血管炎相关的弥漫性肺泡出血作为乳腺癌的一种表现形式。这种副肿瘤性血管炎的治疗方法包括使用皮质类固醇和血浆置换，血浆置换是一种非常有用的技术，可去除内皮攻击者（循环抗体），作为争取时间做出针对疾病改善的适当治疗决策的策略，但它也可能与多种严重不良反应相关，我们的病例对此进行了说明。
