Ikeda Saori, Watanabe Kageaki, Misawa Kazuhito, Yanagawa Noriyo, Hosomi Yukio
Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-0021, Japan.
Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-0021, Japan.
IDCases. 2025 Apr 19;40:e02234. doi: 10.1016/j.idcr.2025.e02234. eCollection 2025.
We report a rapidly progressive case of tuberculous pleurisy and pericarditis. A 59-year-old, male patient with non-small-cell lung cancer commenced pembrolizumab monotherapy one month before but soon thereafter had fevers and dyspnea. Radiography revealed increased right pleural effusion, novel left pleural effusion and cardiomegaly, which had been absent 10 days earlier when a reduction in the target lesion was confirmed. Computed tomography revealed the presence of pericardial fluid. Analysis of the pleural effusion didn't detect malignancy; however, the culture was positive for tuberculosis. It suggests that pembrolizumab may have induced severe inflammation leading to the rapid progression of the disease.
我们报告一例结核性胸膜炎和心包炎快速进展的病例。一名59岁男性非小细胞肺癌患者在一个月前开始接受派姆单抗单药治疗，但此后不久出现发热和呼吸困难。影像学检查显示右侧胸腔积液增多、新发左侧胸腔积液和心脏扩大，而10天前确认靶病灶缩小时尚无这些表现。计算机断层扫描显示存在心包积液。胸腔积液分析未检测到恶性肿瘤；然而，培养结果显示结核呈阳性。这表明派姆单抗可能诱发了严重炎症，导致疾病快速进展。
