Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Japan.
Department of Respiratory Medicine, Kyorin University School of Medicine, Japan.
Intern Med. 2023 Apr 15;62(8):1203-1206. doi: 10.2169/internalmedicine.0256-22. Epub 2022 Sep 6.
A 46-year-old woman with lung cancer who received chemotherapy was admitted to our hospital for lower-lobe bilateral ground-glass opacity (GGO). GGO developed after the lung cancer diagnosis, deteriorated after the initiation of osimertinib, and incompletely decreased after interrupting osimertinib; therefore, flexible bronchoscopy was performed. Transbronchial lung biopsy histology and anti-granulocyte/macrophage colony-stimulating factor autoantibody positivity revealed autoimmune pulmonary alveolar proteinosis (aPAP) that did not require treatment. This rare case of aPAP comorbid with lung cancer suggested that using PAP findings to differentiate from drug-induced lung injury or lymphangitis is difficult and that osimertinib was suspected to exacerbate aPAP.
一位 46 岁的肺癌女性患者在接受化疗后因双肺下叶磨玻璃影（GGO）入住我院。该 GGO 于肺癌诊断后出现，在奥希替尼治疗开始后恶化，且在中断奥希替尼后不完全消退，因此进行了纤维支气管镜检查。经支气管肺活检组织学和抗粒细胞/巨噬细胞集落刺激因子自身抗体阳性显示自身免疫性肺泡蛋白沉积症（aPAP），无需治疗。该罕见的肺癌合并 aPAP 病例表明，使用 PAP 结果来区分药物性肺损伤或淋巴管炎很困难，且奥希替尼可能加重 aPAP。
