title: [Iatrogenic pulmonary necrosis due to hyperselective chemotherapy].
abstract: BACKGROUND
  The management of cancer requires regular access to the central venous system. We report here, a case of a central venous access system causing pulmonary necrosis and abscess.
  
  
  METHODS
  A 48 year old woman with a past history of B-cell lymphoma presented with a relapse of her disease. A subcutaneous central venous access port was placed in the right brachiocephalic area with puncture of the subclavian vein. She received three doses of chemotherapy. Eight days later, she consulted the emergency department on account of right-sided chest pain. Examination revealed a right-sided pleural effusion. The chest x-ray showed the tip of the catheter at the right pulmonary hilum. A CT scan confirmed that the tip of the central venous catheter was located in a branch of the right lower lobe pulmonary artery and was surrounded by consolidation in the right middle and lower lobes. The progress was marked by the development of a lung abscess despite removal of the central venous access system. Subsequent surgery led to satisfactory resolution.
  
  
  CONCLUSIONS
  We report a dramatic case that reminds us that placement of a central venous access system requires a sound technique and regular radiological surveillance.
authors.affiliation: Service d'Onco-Hématologie, Centre Hospitalier de Saint-Quentin, avenue Michel-de-l'Hospital, 02100 Saint-Quentin, France.
authors.forename: P
authors.initials: P
authors.lastname: Vanelslander
authors.forename: S
authors.initials: S
authors.lastname: Richard
authors.forename: Y
authors.initials: Y
authors.lastname: Bouguerrouche
authors.forename: M
authors.initials: M
authors.lastname: Bouketouche
authors.forename: A
authors.initials: A
authors.lastname: Youssef
authors.forename: M
authors.initials: M
authors.lastname: Kanaan
authors.forename: P
authors.initials: P
authors.lastname: Berna
authors.forename: Y
authors.initials: Y
authors.lastname: Douadi
authors.forename: R
authors.initials: R
authors.lastname: Garidi
authors.forename: C
authors.initials: C
authors.lastname: Dayen
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use / Q000633:toxicity*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007049:Iatrogenic Disease; D008168:Lung / Q000187:drug effects* / Q000473:pathology* / Q000601:surgery; D008169:Lung Abscess / Q000139:chemically induced / Q000473:pathology / Q000601:surgery; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D019300:Medical Errors; D008875:Middle Aged; D009336:Necrosis; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011651:Pulmonary Artery; D018714:Radiotherapy, Adjuvant; D012074:Remission Induction; D014057:Tomography, X-Ray Computed