title: Systemic tumor embolism mimicking gefitinib ('IRESSA')-induced interstitial lung disease in a patient with lung cancer.
abstract: We describe a 55-year-old man with advanced adenocarcinoma of the lung who received gefitinib ('IRESSA'). After gefitinib administration for 7 months, computed tomography scan of the chest demonstrated diffuse ground glass opacity and he was suspected to have developed gefitinib-induced interstitial lung disease (ILD). However, transbronchial lung biopsy (TBLB) revealed tumor cells in the middle-size lung vessels. Afterwards, multiple infarctions of the brain, spleen and left kidney were detected. Then, he was considered to have developed systemic tumor emboli, a rare complication. The clinical presentation of this patient was difficult to discriminate from that of ILD, and TBLB was useful in the differential diagnosis.
authors.affiliation: Department of Hematology, Oncology and Respiratory Medicine Okayama University Graduate School of Medicine and Dentistry, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Umemura
authors.forename: Daizo
authors.initials: D
authors.lastname: Kishino
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tabata
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kiura
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Hotta
authors.forename: Kenji
authors.initials: K
authors.lastname: Nishii
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tanimoto
authors.forename: Arihiko
authors.initials: A
authors.lastname: Kanehiro
authors.forename: Kenji
authors.initials: K
authors.lastname: Notohara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ueoka
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000188:drug therapy; D000970:Antineoplastic Agents / Q000009:adverse effects; D003937:Diagnosis, Differential; D000077156:Gefitinib; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000209:etiology*; D008175:Lung Neoplasms / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011799:Quinazolines / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D000077156:Gefitinib