Pulmonary toxicity by a cytotoxic agent, S-1.
A 72-year-old man with tongue carcinoma complained of dyspnea on exertion 18 days after starting treatment with S-1. Chest radiograph and CT scan suggested diffuse interstitial lesions with ground glass opacity on both lungs. Bronchoalveolar lavage and transbronchial lung biopsy revealed moderate lymphocyte infiltration with granuloma. Drug lymphocyte stimulation test was positive against tegafur, one of the components of S-1. These findings were consistent with S-1-induced lung injury. Both his symptoms and the radiographic findings were resolved dramatically after high-dose corticosteroid therapy. Clinicians should be aware that S-1 has the potential to cause lung injury when it is included in chemotherapy.
Tada
Yuji
Y
Respirology, Chiba University. ytada@faculty.chiba-u.jp
Takiguchi
Yuichi
Y
Fujikawa
Ayako
A
Kitamura
Atsushi
A
Kurosu
Katsushi
K
Hiroshima
Kenzo
K
Sakao
Seiichiro
S
Kasahara
Yasunori
Y
Tanabe
Nobuhiro
N
Tatsumi
Koichiro
K
Kuriyama
Takayuki
T
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D004338:Drug Combinations; D006801:Humans; D008168:Lung / Q000473:pathology; D008297:Male; D010094:Oxonic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D012128:Respiratory Distress Syndrome / Q000139:chemically induced* / Q000473:pathology; D005641:Tegafur / Q000009:adverse effects* / Q000627:therapeutic use; D014062:Tongue Neoplasms / Q000188:drug therapy
D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid