title: Eosinophilic pneumonia and thoracic metastases as an initial manifestation of prostatic carcinoma.
abstract: We herein report an 80-year-old man with prostatic carcinoma who developed eosinophilic pneumonia and intrathoracic metastases. He presented with shortness of breath, cough, and fever as a chief complaint. Chest X-ray and computed tomography showed bilateral pulmonary nodules, intrathoracic lymphadenopathy, and right-sided consolidation. Positron emission tomography (PET) using (18)F-fluorodeoxyglucose (FDG) showed poor uptake in these nodules and lymph nodes. The patient subsequently received a pelvic computed tomography scan, which revealed a massively enlarged prostate. The serum prostate specific antigen level was elevated to 4,181.2 ng/mL, and a transrectal biopsy revealed prostatic adenocarcinoma. Based on the morphological and immunohistochemical findings, the nodules in the lung and the lymph nodes were diagnosed as secondary neoplasm from the prostate. As for right-sided consolidation, remarkable bronchoalvelar lavage fluid eosinophilia was detected, that was compatible with eosinophilic pneumonia. Eosinophilic pneumonia in this case disappeared and has not recurred by treatment of prostatic carcinoma and steroid therapy for a week, and was regarded to be tumor-associated. Although prostatic carcinoma with an initial manifestation of intrathoracic metastases and eosinophilic pneumonia is uncommon, physicians should suspect the condition. In addition, we should also keep in mind that prostatic carcinoma sometimes shows poor uptake in FDG-PET. PET: Positron emission tomography, FDG: (18)F-flouorodeoxyglucose.
authors.affiliation: Respiratory Medicine, Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science. ishiguro@med3.m.kanazawa-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishiguro
authors.forename: Hideharu
authors.initials: H
authors.lastname: Kimura
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Araya
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Minato
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Katayama
authors.forename: Masahide
authors.initials: M
authors.lastname: Yasui
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kasahara
authors.forename: Masaki
authors.initials: M
authors.lastname: Fujimura
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology*; D000369:Aged, 80 and over; D001706:Biopsy; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D011657:Pulmonary Eosinophilia / Q000175:diagnosis*; D013899:Thoracic Neoplasms / Q000175:diagnosis* / Q000556:secondary*
chemical_list: D019788:Fluorodeoxyglucose F18