Drug-induced pneumonitis detected earlier by 18F-FDG-PET than by high-resolution CT: a case report with non-Hodgkin's lymphoma.
Drug-induced pneumonitis is a serious and an unpredictable side effect of chemotherapy in patients with malignant lymphoma. We present the case of a 51-year-old man who developed drug-induced pneumonitis during chemotherapy for non-Hodgkin's lymphoma in which pneumonitis was detected earlier by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) than by high-resolution computed tomography (HRCT). After five courses of chemotherapy, 18F-FDG-PET was performed for assessing residual lesions, and diffuse lung uptake was incidentally observed. No symptoms were present, and HRCT performed immediately following PET revealed no abnormalities. Mild dyspnea appeared 3 days after PET, and additional HRCT revealed patchy ground-glass opacities disseminated with the appearance of interlobular septum thickening. Drug-induced pneumonitis was finally diagnosed, and treatment was initiated. 18F-FDG-PET can be an imaging modality for detecting drug-induced pneumonitis at an extremely early stage in which HRCT is incapable of revealing any abnormal changes.
Yamane
Tomohiko
T
Department of Radiology, Daiyukai General Hospital, 1-9-9 Sakura, Ichinomiya, Aichi, 491-8551, Japan. yamane@naramed-u.ac.jp
Daimaru
Osami
O
Ito
Satoshi
S
Nagata
Takeshi
T
Yoshiya
Kazuhiko
K
Fukaya
Nobuyuki
N
Ito
Shinichi
S
Imai
Teruhiko
T
Uchida
Hideo
H
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000139:chemically induced* / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods*; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone