title: Nivolumab-induced organizing pneumonia in a melanoma patient.
abstract: We report the case of a 70-year-old woman with vaginal melanoma and multiple metastases in the lung. After the third dose of nivolumab, decreased room-air resting arterial oxygen saturation with bilateral basal fine crackles on auscultation developed despite the absence of respiratory symptoms. Computed tomography showed ground-glass opacities with airspace consolidations scattered with a peculiar distribution, and most were observed around the existing metastatic tumors in the lung. From the 42nd day to the 56th day after the last administration of nivolumab, she received dexamethasone 1-2 mg/body for the prevention of adverse events after stereotactic radiation for brain metastasis. At 3 months after the last administration of nivolumab, a computed tomography scan revealed improvement of the pneumonia and a decreased size and number of metastatic lesions in the lung, although some lesions showed enlargement. Further examination is needed to clarify the relationship between the pattern of pneumonia after Nivo therapy and clinical effects.
authors.affiliation: Department of Dermatology, Shinshu University School of Medicine, Matsumoto.
authors.forename: Tasuku
authors.initials: T
authors.lastname: Sano
authors.affiliation: Department of Dermatology, Shinshu University School of Medicine, Matsumoto uhara@shinshu-u.ac.jp.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Uhara
authors.affiliation: Department of Dermatology, Shinshu University School of Medicine, Matsumoto.
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Mikoshiba
authors.affiliation: Department of Dermatology, Shinshu University School of Medicine, Matsumoto.
authors.forename: Aya
authors.initials: A
authors.lastname: Kobayashi
authors.affiliation: Department of Dermatology, Shinshu University School of Medicine, Matsumoto.
authors.forename: Ryuhei
authors.initials: R
authors.lastname: Uchiyama
authors.affiliation: First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tateishi
authors.affiliation: First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Department of Dermatology, Shinshu University School of Medicine, Matsumoto.
authors.forename: Ryuhei
authors.initials: R
authors.lastname: Okuyama
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D018549:Cryptogenic Organizing Pneumonia / Q000139:chemically induced* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008545:Melanoma / Q000188:drug therapy*; D000077594:Nivolumab; D012878:Skin Neoplasms / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D014625:Vaginal Neoplasms / Q000188:drug therapy*
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000077594:Nivolumab
keywords: PD-1; drug induced lung disease; melanoma; nivolumab