Internal Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea.
Thorac Cancer. 2022 Aug;13(16):2390-2393. doi: 10.1111/1759-7714.14561. Epub 2022 Jul 6.
Radiation therapy can cause radiation pneumonitis, organizing pneumonia, and lung fibrosis. Radiation-induced pseudomembranous bronchitis is a rare condition. Here, we describe a rare case each of pseudomembranous tracheobronchitis and pseudomembrane with total bronchial obstruction which developed after thoracic radiotherapy. A 50-year-old man presented paroxysmal severe cough 1 month after concurrent chemoradiotherapy for small-cell lung cancer. Bronchoscopy revealed a whitish membrane in the trachea and bronchus, which were the fields of radiation. Another 60-year-old man complained of dyspnea 7 months after radiation therapy for metastatic lymph node adenocarcinoma. Bronchoscopy demonstrated a membrane with total obstruction of right lower lobar bronchus, which was the area of radiation. The pathological findings of histological examination in both cases demonstrated radiation-induced pseudomembranous tracheobronchitis. Patients in both cases responded well to steroids and the pseudomembrane disappeared. If patients who have received thoracic radiation therapy complain of persistent cough, bronchoscopy may be helpful.
放射治疗可引起放射性肺炎、机化性肺炎和肺纤维化。放射性假膜性支气管炎是一种罕见的疾病。在这里，我们描述了两例罕见的放射性假膜性气管支气管炎和假膜性完全性支气管阻塞病例，均发生于胸部放射治疗后。一名 50 岁男性，在小细胞肺癌同步放化疗后 1 个月出现阵发性剧烈咳嗽。支气管镜检查显示气管和支气管有白色膜状物，这些部位是放射治疗的区域。另一名 60 岁男性，在转移性淋巴结腺癌放射治疗后 7 个月出现呼吸困难。支气管镜检查显示右肺下叶支气管完全阻塞的膜状物，该部位是放射治疗的区域。这两例患者的组织病理学检查结果均显示为放射性假膜性气管支气管炎。这两例患者对类固醇治疗反应良好，假膜消失。如果接受过胸部放射治疗的患者持续咳嗽，支气管镜检查可能会有所帮助。
