Multiple pulmonary nodules: an unusual presentation of fludarabine pulmonary toxicity: case report and review of literature.
Fludarabine monophosphate, a purine analogue is used in the treatment of lymphoid malignancies. A 73-year-old woman presented with fever and cough 2 weeks after completing the third cycle of fludarabine for chronic lymphocytic leukemia (CLL). Chest roentgenogram showed multiple pulmonary nodules. Pulmonary histopathology demonstrated a mononuclear interstitial infiltrate without evidence of malignant, infectious, granulomatous, or vascular causes. Her symptoms and pulmonary nodules resolved following treatment with corticosteroids. To our knowledge, four cases of interstitial pneumonitis associated with fludarabine have been reported in medical literature. Fludarabine induced lung toxicity must be considered in all patients who develop unexplained lung disease while receiving fludarabine. It is reversible with discontinuation of drug and administration of corticosteroids. This case extends the spectrum of fludarabine pulmonary toxicity to include pulmonary nodules.
Department of Oncology, Providence Hospitals and Medical Centers, Southfield, Michigan 48037, USA. aarushgarg@hotmail.com
Sandeep
S
Garg
Manisha S
MS
Garg
Neil
N
Basmaji
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy; D008171:Lung Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D011241:Prednisone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014740:Vidarabine / Q000009:adverse effects* / Q000031:analogs & derivatives
D000970:Antineoplastic Agents; D014740:Vidarabine; C024352:fludarabine; D011241:Prednisone