[Obliterative bronchiolitis with organising pneumonia following FOLFOX 4 chemotherapy].
BACKGROUND
FOLFOX 4 chemotherapy (5-fluorouracil, leucovorin and oxaliplatin) is the standard adjuvant treatment for stage III colon cancer. The principal secondary effects described are haematological, gastro-intestinal or neurological. A single case of obliterative bronchiolitis with organising pneumonia has been described recently.


METHODS
We report the case of a female patient aged 74 years who, after 12 courses of FOLFOX 4 chemotherapy, developed acute onset of severe shortness of breath and a dry cough but remained afebrile. A thoracic CT-scan showed symmetrical bilateral interstitial infiltration that was reticular in appearance, and predominantly basal and peripheral in distribution. Broncho-alveolar lavage revealed an alveolitis with 9% eosinophils and 4% neutrophils. Transbronchial biopsies showed the appearances of obliterative bronchiolitis with organising pneumonia. Systemic corticosteroid treatment led to a remarkable clinical and functional improvement.


CONCLUSIONS
To our knowledge, this is the second case of obliterative bronchiolitis with organising pneumonia that has been described following adjuvant treatment based on FOLFOX 4.
Service de pneumologie, Grand hôpital de Charleroi, rue de la Duchère, 6 6060 Gilly, Belgique.
C
C
Dahlqvist
A
A
Fremault
J
J
Carrasco
B
B
Colinet
D000208:Acute Disease; D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use / Q000633:toxicity*; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D018549:Cryptogenic Organizing Pneumonia / Q000139:chemically induced* / Q000473:pathology; D003937:Diagnosis, Differential; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use / Q000633:toxicity; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use / Q000633:toxicity; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000627:therapeutic use / Q000633:toxicity; D011650:Pulmonary Alveoli / Q000473:pathology; D014057:Tomography, X-Ray Computed
D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil