Systemic tumor embolism mimicking gefitinib ('IRESSA')-induced interstitial lung disease in a patient with lung cancer.
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.
Umemura
Shigeki
S
Department of Hematology, Oncology and Respiratory Medicine Okayama University Graduate School of Medicine and Dentistry, Japan.
Kishino
Daizo
D
Tabata
Masahiro
M
Kiura
Katsuyuki
K
Hotta
Katsuyuki
K
Nishii
Kenji
K
Tanimoto
Yasushi
Y
Kanehiro
Arihiko
A
Notohara
Kenji
K
Ueoka
Hiroshi
H
Tanimoto
Mitsune
M
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*
D000970:Antineoplastic Agents; D011799:Quinazolines; D000077156:Gefitinib