1
|
Kano Y, Okada H, Murata K. Hot lung sign in intravascular lymphoma. BMJ Case Rep 2023; 16:e256987. [PMID: 37479489 PMCID: PMC10364151 DOI: 10.1136/bcr-2023-256987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023] Open
Affiliation(s)
- Yasuhiro Kano
- Department of Emergency and General Medicine, Tokyo Metropolitan Tama Medical Center, Fuchu, Japan
| | - Haruka Okada
- Department of Pathology, Tokyo Metropolitan Tama Medical Center, Fuchu, Japan
| | - Kengo Murata
- Department of Emergency and General Medicine, Tokyo Metropolitan Tama Medical Center, Fuchu, Japan
- Department of Respiratory Medicine and Oncology, Tokyo Metropolitan Tama Medical Center, Fuchu, Japan
| |
Collapse
|
2
|
Jennane S, Ababou M, El Haddad M, Ait Sahel O, Mahtat EM, El Maaroufi H, Doudouh A, Doghmi K. Bleomycin-Induced Lung Toxicity in Hodgkin's Lymphoma: Risk Factors in the Positron Emission Tomography Era. Cureus 2022; 14:e23993. [PMID: 35419251 PMCID: PMC8994685 DOI: 10.7759/cureus.23993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction Bleomycin is a major antimitotic agent in the first-line treatment for Hodgkin's lymphoma. The main limitation of its use is its pulmonary toxicity. The objectives of this study are to find out the risk factors for the occurrence of bleomycin-induced lung toxicity in patients with Hodgkin's lymphoma and, on the other hand, to determine if positron emission tomography scan is a reliable means of early detection of this toxicity. Methods This is a retrospective study conducted in the clinical Hematology Department of Mohammed V Military Instruction Hospital, Rabat, Morocco. All patients with Hodgkin's lymphoma and treated with a bleomycin-based chemotherapy were included. The impact of different clinical and biological factors on the risk of bleomycin-induced lung toxicity occurrence was assessed using univariate and multivariate logistic regression. The benefit of positron emission tomography, usually performed as part of the re-assessment of Hodgkin’s lymphoma after two and four cycles, has been evaluated in the detection of bleomycin-induced lung toxicity. Results Among 124 patients included in the study, 18 (14.5%) patients experienced bleomycin-induced lung toxicity. On multivariate analysis, smoking (p = 0.038) and the use of the ABVD regimen (doxorubicin, bleomycin, vinblastine, and dacarbazine) compared to the escalated BEACOPPe regimen (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) (p = 0.018) were statistically significant risk factors. After two and four courses of therapy, the positron emission tomography was able to predict the occurrence of bleomycin-induced lung toxicity before the appearance of clinical symptoms only in 36.4 % and 12.5% of patients, respectively. Conclusion Studies to identify risk factors for the development of bleomycin-induced lung toxicity are crucial to reduce toxicity in the treatment of Hodgkin's lymphoma. However, two- and four-cycle positron emission tomography scans cannot be considered as a reliable means of early detection of this toxicity.
Collapse
|
3
|
Rasheed R, Raza Naqi SA, Saeed N, Rasheed S. Proactive Response of Nuclear Medicine Department in Current Coronavirus Disease-19 Pandemic. Indian J Nucl Med 2020; 35:278-280. [PMID: 33082699 PMCID: PMC7537930 DOI: 10.4103/ijnm.ijnm_64_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Rashid Rasheed
- Department of Nuclear Medicine and PET/CT, Kuwait Cancer Control Center, Ministry of Health, Shuwaikh, Kuwait
- Department of Chemistry, Government College University, Faisalabad, Pakistan
| | - Syed Ali Raza Naqi
- Department of Chemistry, Government College University, Faisalabad, Pakistan
| | - Nidda Saeed
- Department of Primary and Secondary Healthcare, Pakistan Drug testing laboratory, Lahore, Pakistan
| | - Shahid Rasheed
- Department of Computer Sciences, Comsats University, Islamabad, Wah Campus, Rawalpindi Punjab, Pakistan
| |
Collapse
|
4
|
Willemsen AECAB, Tol J, van Erp NP, Jonker MA, de Boer M, Meek B, de Jong PC, van Moorsel C, Gerritsen WR, Grutters JC, van Herpen CML. Prospective Study of Drug-induced Interstitial Lung Disease in Advanced Breast Cancer Patients Receiving Everolimus Plus Exemestane. Target Oncol 2020; 14:441-451. [PMID: 31325105 PMCID: PMC6684805 DOI: 10.1007/s11523-019-00656-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Everolimus-related interstitial lung disease (ILD) (also: pneumonitis) poses a difficulty for physicians, as it is hard to discriminate ILD from other causes of respiratory symptoms and to decide on safe treatment continuation. OBJECTIVE We investigated the capability of pulmonary function tests (PFT), plasma biomarkers, everolimus pharmacokinetics, and FDG-PET to discriminate between everolimus-related ILD and other causes of respiratory problems and to predict the severity of ILD. PATIENTS AND METHODS Women starting treatment with everolimus plus exemestane for advanced breast cancer were included. At baseline and during the first 3 months, respiratory symptoms, PFT with diffusion capacity of the lungs for carbon monoxide corrected for hemoglobin (DLCOc) and forced vital capacity, serum plasma biomarkers (including SP-D and YKL-40), everolimus trough concentration, and 18F-FDG-PET were prospectively recorded. RESULTS Twenty-seven (out of 29 included) patients were evaluable for analysis. Fifteen patients (56%) developed everolimus-related respiratory signs or symptoms and four patients (15%) needed everolimus discontinuation and received corticosteroids. Change in DLCOc differentiated ILD from alternative diagnoses with 0.91 sensitivity and 0.78 specificity. Decrease in DLCOc (non-significant) was greatest in patients who needed everolimus discontinuation. Serum SP-D and YKL-40 could differentiate ILD from alternative diagnoses with 0.83 and 0.83 sensitivity, and 0.85 and 0.62 specificity, respectively. 18F-FDG-PET abnormalities did not precede clinical symptoms. No relationship between ILD and everolimus trough concentration was found. CONCLUSIONS This study shows that everolimus-related ILD occurs frequently. Prospective monitoring of DLCOc in combination with measurement of serum SP-D and YKL-40 appear useful to discriminate ILD from other causes of respiratory symptoms. Clinicaltrials.gov identifier: NCT01978171.
Collapse
Affiliation(s)
- Annelieke E C A B Willemsen
- Department of Medical Oncology, Radboud university medical center, route 452, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Jolien Tol
- Department of Medical Oncology, Jeroen Bosch Hospital, P.O. Box 90153, 5200 ME, 's Hertogenbosch, The Netherlands
| | - Nielka P van Erp
- Department of Pharmacy, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Marianne A Jonker
- Department for Health Evidence, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Maaike de Boer
- Division of Medical Oncology Department of Internal Medicine, GROW-School of Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bob Meek
- Department of Pulmonology, St. Antonius Hospital, Centre of Interstitial Lung Diseases, Nieuwegein, The Netherlands
| | - Paul C de Jong
- Department of Medical Oncology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Coline van Moorsel
- Department of Pulmonology, St. Antonius Hospital, Centre of Interstitial Lung Diseases, Nieuwegein, The Netherlands.,Division Heart & Lungs, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Winald R Gerritsen
- Department of Medical Oncology, Radboud university medical center, route 452, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Jan C Grutters
- Department of Pulmonology, St. Antonius Hospital, Centre of Interstitial Lung Diseases, Nieuwegein, The Netherlands.,Division Heart & Lungs, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Carla M L van Herpen
- Department of Medical Oncology, Radboud university medical center, route 452, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| |
Collapse
|
5
|
Abstract
Intravascular large B-cell lymphoma is a rare type of non-Hodgkin lymphoma characterized by intravascular proliferation of clonal lymphocytes within the lumen of small vessels, which is often fatal. Diffuse FDG uptake in the lung without clear/evident CT findings, "hot lung," is quasi-pathognomonic for lung intravascular large B-cell lymphoma. In this report, we present the case of a 43-year-old man who was diagnosed as having intravascular lymphoma thanks to this rare finding.
Collapse
|
6
|
Beyhan Sagmen S, Comert S, Turan Erkek E, Küçüköz Uzun A, Doğan C, Yılmaz G, Kıral N, Fidan A, Yılmaz Haksal Ç, Torun Parmaksız E. Can We Predict Bleomycin Toxicity with PET-CT? Acta Haematol 2019; 142:171-175. [PMID: 31454795 DOI: 10.1159/000502374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/26/2019] [Indexed: 01/30/2023]
Abstract
AIM Bleomycin is an antitumor antibiotic used successfully to treat a variety of malignancies, predominantly germ cell tumors and Hodgkin's lymphoma (HL). The major limitation of bleomycin therapy is the potential for life-threatening interstitial pulmonary fibrosis. Early identification of asymptomatic patients who may develop toxicity is important. We aimed to evaluate fluorodeoxyglucose positron-emission tomography (FDG-PET/CT) findings to predict bleomycin toxicity (BT) early after chemotherapy with doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy before clinical symptoms and radiological changes occur. MATERIALS AND METHODS HL patients who were treated with ABVD were evaluated. SUVmax values of lung parenchyma were analyzed in FDG-PET/CT at diagnosis and after 4 cycles of chemotherapy in all patients. At the end of the chemotherapy cycles, lung parenchymal SUVmax values of patients with BT and without BT were compared statistically. RESULTS Twenty (66.7%) male and 10 (33.3%) female patients with HL were included. Five (16.7%) HL patients developed BT. In 3 HL patients, BT was determined after 5 cycles and in 2 patients, BT was seen after 6 cycles. In all 5 of these patients with BT, FDG uptake in PET-CT was increased after 4 cycles of chemotherapy and BT was predicted before clinical and radiological findings by FDG-PET/CT. After 4 cycles of chemotherapy, lung parenchymal SUVmax of patients with BT (3.24 ± 0.76) was significantly higher than in patients without toxicity (1.84 ± 0.52) (p < 0.001). In patients with BT, a significant increase was established in lung parenchymal SUVmax after 4 cycles of chemotherapy when compared to the time of diagnosis (p = 0.043). CONCLUSION BT can be fatal. Early detection of BT is essential in clinical practice. FDG-PET/CT can predict BT before clinical and radiological findings occur.
Collapse
Affiliation(s)
- Seda Beyhan Sagmen
- Pulmonary Medicine, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Kartal, Turkey,
| | - Sevda Comert
- Pulmonary Medicine, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Kartal, Turkey
| | - Esra Turan Erkek
- Hematology, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Kartal, Turkey
| | - Aysun Küçüköz Uzun
- Nuclear Medicine, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Kartal, Turkey
| | - Coşkun Doğan
- Pulmonary Medicine, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Kartal, Turkey
| | - Guven Yılmaz
- Hematology, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Kartal, Turkey
| | - Nesrin Kıral
- Pulmonary Medicine, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Kartal, Turkey
| | - Ali Fidan
- Pulmonary Medicine, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Kartal, Turkey
| | - Çağla Yılmaz Haksal
- Nuclear Medicine, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Kartal, Turkey
| | - Elif Torun Parmaksız
- Pulmonary Medicine, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Kartal, Turkey
| |
Collapse
|
7
|
Spencer J, Dusing R, Yap W, Hill J, Walter C. Intravascular large B-cell lymphoma presenting with diffusely increased pulmonary fluorodeoxyglucose uptake without corresponding CT abnormality. Radiol Case Rep 2018; 14:260-264. [PMID: 30510608 PMCID: PMC6260434 DOI: 10.1016/j.radcr.2018.10.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 10/30/2018] [Accepted: 10/30/2018] [Indexed: 12/14/2022] Open
Abstract
A 60-year-old male presented with complaints of dyspnea, intermittent fever, and 40 pounds of weight loss over the previous 9 months and was admitted for acute hypoxemic respiratory failure. Labs demonstrated elevated inflammatory markers, mild anemia, and thrombocytopenia. Fluorodeoxyglucose-positron emission tomography scan demonstrated diffusely increased pulmonary fluorodeoxyglucose uptake without corresponding abnormality on CT images. Excisional lung biopsy demonstrated intravascular large B-cell lymphoma (IV-LBCL). Presentation, imaging findings, and diagnosis of IV-LBCL will be discussed, as well as differential considerations for pulmonary involvement by IV-LBCL.
Collapse
Affiliation(s)
- Jayden Spencer
- Department of Radiology, Kansas University Hospital, 3901 Rainbow Blvd, MS 4032, Kansas City, KS, USA
| | - Reginald Dusing
- Department of Radiology, Kansas University Hospital, 3901 Rainbow Blvd, MS 4032, Kansas City, KS, USA
| | - Wendell Yap
- Department of Radiology, Kansas University Hospital, 3901 Rainbow Blvd, MS 4032, Kansas City, KS, USA
| | - Jacqueline Hill
- Department of Radiology, Kansas University Hospital, 3901 Rainbow Blvd, MS 4032, Kansas City, KS, USA
| | - Carissa Walter
- Department of Radiology, Kansas University Hospital, 3901 Rainbow Blvd, MS 4032, Kansas City, KS, USA
| |
Collapse
|
8
|
Zhao M, Zhang W. Early detection value of 18F-FDG-PET/CT for drug-induced lung injury in lymphoma. Ann Hematol 2018; 98:909-914. [PMID: 30460376 DOI: 10.1007/s00277-018-3558-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 11/15/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Meixin Zhao
- Department of Nuclear Medicine, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Weifang Zhang
- Department of Nuclear Medicine, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.
| |
Collapse
|
9
|
Matsuno O. Drug-induced interstitial lung disease: mechanisms and best diagnostic approaches. Respir Res 2012; 13:39. [PMID: 22651223 PMCID: PMC3426467 DOI: 10.1186/1465-9921-13-39] [Citation(s) in RCA: 172] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 05/16/2012] [Indexed: 02/06/2023] Open
Abstract
Drug-induced interstitial lung disease (DILD) is not uncommon and has many clinical patterns, ranging from benign infiltrates to life-threatening acute respiratory distress syndrome. There are two mechanisms involved in DILD, which are probably interdependent: one is direct, dose-dependent toxicity and the other is immune-mediated. Cytotoxic lung injury may result from direct injury to pneumocytes or the alveolar capillary endothelium. Drugs can induce all types of immunological reactions described by Gell and Coombs; however, most reactions in immune-mediated DILD may be T cell-mediated. DILD can be difficult to diagnose; diagnosis is often possible by exclusion alone. Identifying the causative drug that induces an allergy or cytotoxicity is essential for preventing secondary reactions. One method to confirm the diagnosis of a drug-induced disease is re-exposure or re-test of the drug. However, clinicians are reluctant to place patients at further risk of illness, particularly in cases with severe drug-induced diseases. Assessment of cell-mediated immunity has recently increased, because verifying the presence or absence of drug-sensitized lymphocytes can aid in confirmation of drug-induced disease. Using peripheral blood samples from drug-allergic patients, the drug-induced lymphocyte stimulation test (DLST) and the leukocyte migration test (LMT) can detect the presence of drug-sensitized T cells. However, these tests do not have a definite role in the diagnosis of DILD. This study explores the potential of these new tests and other similar tests in the diagnosis of DILD and provides a review of the relevant literature on this topic.
Collapse
Affiliation(s)
- Osamu Matsuno
- Division of Medicine for Allergic Disease, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Japan.
| |
Collapse
|
10
|
Wagner T, Brechemier D, Dugert E, Le Guellec S, Julian A, Hitzel A, Beyne-Rauzy O. Diffuse pulmonary uptake on FDG-PET with normal CT diagnosed as intravascular large B-cell lymphoma: a case report and a discussion of the causes of diffuse FDG uptake in the lungs. Cancer Imaging 2012; 12:7-12. [PMID: 22275725 PMCID: PMC3266578 DOI: 10.1102/1470-7330.2012.0002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A 71-year-old woman was admitted to our hospital with asthenia, weight loss, fever, cognitive impairment and shortness of breath. Physical examination showed hemiparesis and cerebellar ataxia. There was no superficial lymphadenopathy. Blood tests showed raised levels of C-reactive protein and lactate dehydrogenase. Bone marrow aspiration and biopsy were negative. [18F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) showed intense uptake within a right apical nodule and intense and diffuse uptake of FDG in the lungs without corresponding structural CT abnormality. Lung biopsy showed intravascular large B-cell lymphoma (IVLBCL). FDG-PET findings in IVLBCL and causes of diffuse FDG lung uptake with and without CT abnormalities are discussed.
Collapse
Affiliation(s)
- T Wagner
- Nuclear Medicine Department, Toulouse Purpan University Hospital, Toulouse, France.
| | | | | | | | | | | | | |
Collapse
|
11
|
Hadjinicolaou AV, Nisar MK, Parfrey H, Chilvers ER, Ostor AJK. Non-infectious pulmonary toxicity of rituximab: a systematic review. Rheumatology (Oxford) 2011; 51:653-62. [DOI: 10.1093/rheumatology/ker290] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
|
12
|
Association Between Pulmonary Uptake of Fluorodeoxyglucose Detected by Positron Emission Tomography Scanning After Radiation Therapy for Non–Small-Cell Lung Cancer and Radiation Pneumonitis. Int J Radiat Oncol Biol Phys 2011; 80:1365-71. [DOI: 10.1016/j.ijrobp.2010.04.021] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 03/29/2010] [Accepted: 04/12/2010] [Indexed: 11/17/2022]
|
13
|
Rituximab-Related Pulmonary Toxicity. PULMONARY INVOLVEMENT IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES 2011. [PMCID: PMC7123637 DOI: 10.1007/978-3-642-15742-4_64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report the case of an 80-year-old man treated for follicular grade 3B non-Hodgkin’s lymphoma (NHL). Immunochemotherapy consisted of rituximab (375 mg/m2) and CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) every 21 days. Since the patient complained of mild dyspnea on effort with bilateral basilar crackles audible on auscultation, PET-CT was performed and showed disappearance of the initial 18F-FDG uptake, but new abnormal sites of 18F-FDG uptake were evident in the sub-pleural areas of the lung, mostly on the right side. After starting the fifth cycle of rituximab-CHOP, the dyspnea worsened. Chest-X ray and HRCT were consistent with an interstitial infiltration, including sub-pleural air-space consolidation, and “ground-glass” opacities, small pulmonary cysts and thickening of the interlobular septa were also seen. Trans-bronchial biopsy was performed and revealed interstitial inflammation of the lung parenchyma, as well as swelling and hyperplasia of atypical type II alveolar cells. Alternative diagnoses than drug-related pulmonary toxicity are discussed, and a literature review is provided.
Collapse
|