Richter J E, Hastedt R, Dalton J F, Marshall D, Raymond L W
Cancer. 1979 May;43(5):1607-12. doi: 10.1002/1097-0142(197905)43:5<1607::aid-cncr2820430507>3.0.co;2-0.
A case of interstitial pulmonary fibrosis secondary to bischloronitrosourea (BCNU) in a 49-year-old man with carcinoma of the pancreas is reported. The diagnosis was suggested by deteriorating oxygenation, restrictive changes on pulmonary function studies, and increased interstitial markings radiographically in the lower lung fields. Transbronchial biopsy excluded infectious etiologies and confirmed a bland nonspecific interstitial pulmonary fibrosis of recent origin. The patient responded dramatically to high dose corticosteroids, but relapsed when the corticosteroids were decreased. We believe there is now convincing evidence that prolonged use of BCNU can cause potentially fatal interstitial pulmonary fibrosis. Patients should be followed with serial chest radiographs and pulmonary function studies. If diagnosed early, this process may respond to high dose corticosteroid therapy.
报告了1例49岁胰腺癌男性患者继发于双氯乙基亚硝脲（BCNU）的间质性肺纤维化病例。氧合恶化、肺功能检查显示限制性改变以及胸部X线片显示下肺野间质纹理增加提示了该诊断。经支气管活检排除了感染性病因，并证实为近期发生的非特异性间质性肺纤维化。患者对高剂量皮质类固醇治疗反应显著，但在皮质类固醇减量时复发。我们认为，目前有令人信服的证据表明，长期使用BCNU可导致潜在致命的间质性肺纤维化。应通过系列胸部X线片和肺功能检查对患者进行随访。如果早期诊断，该病程可能对高剂量皮质类固醇治疗有反应。
