title: [A case of imatinib mesylate-induced pneumonitis based on the detection of epithelioid granulomas by video-assisted thoracoscopic surgery biopsy in a patient with chronic myeloid leukemia].
abstract: A 79-year-old man with chronic myeloid leukemia was referred to our department because of dry cough and low-grade fever, 272 days after commencing imatinib mesylate (Gleevec). High resolution computed tomography (HRCT) showed tiny scattered centrilobular nodules and ground-glass opacities throughout both lung fields, suggesting drug-induced pneumonitis. A thoracic video-assisted thoracoscopic surgery (VATS) biopsy specimen from the centrilobular nodules in the right upper lobe demonstrated patchy distribution of epithelioid cell granulomas and intra-alveolar organization. Most of those lesions were predominantly located in the alveolar spaces, which implicated non-transbronchial distribution. Following drug cessation alone, the patient's general condition and radiological abnormalities improved.
authors: Department of Respiratory Medicine, Kyorin University Hospital.
authors: Takashi
authors: T
authors: Koide
authors: Takeshi
authors: T
authors: Saraya
authors: Keitaro
authors: K
authors: Nakamoto
authors: Akira
authors: A
authors: Nakajima
authors: Haruyuki
authors: H
authors: Ishii
authors: Masachika
authors: M
authors: Fujiwara
authors: Hidekatsu
authors: H
authors: Shibata
authors: Teruaki
authors: T
authors: Oka
authors: Tomoyuki
authors: T
authors: Goya
authors: Hajime
authors: H
authors: Goto
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001549:Benzamides; D001706:Biopsy / Q000379:methods*; D006099:Granuloma / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D010879:Piperazines / Q000009:adverse effects*; D011014:Pneumonia / Q000139:chemically induced* / Q000473:pathology; D011743:Pyrimidines / Q000009:adverse effects*; D020775:Thoracic Surgery, Video-Assisted
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate