Systemic Tumor Embolism Mimicking Gefitinib ('IRESSA')-induced Interstitial Lung Disease in a Patient with Lung Cancer

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  • UMEMURA Shigeki
    Department of Hematology, Oncology and Respiratory Medicine Okayama University Graduate School of Medicine and Dentistry
  • KISHINO Daizo
    Department of Pulmonary Medicine, Okayama Institute of Health and Science
  • TABATA Masahiro
    Department of Hematology, Oncology and Respiratory Medicine Okayama University Graduate School of Medicine and Dentistry
  • KIURA Katsuyuki
    Department of Hematology, Oncology and Respiratory Medicine Okayama University Graduate School of Medicine and Dentistry
  • HOTTA Katsuyuki
    Department of Hematology, Oncology and Respiratory Medicine Okayama University Graduate School of Medicine and Dentistry
  • NISHII Kenji
    Department of Pulmonary Medicine, Okayama Institute of Health and Science
  • TANIMOTO Yasushi
    Department of Hematology, Oncology and Respiratory Medicine Okayama University Graduate School of Medicine and Dentistry
  • KANEHIRO Arihiko
    Department of Hematology, Oncology and Respiratory Medicine Okayama University Graduate School of Medicine and Dentistry
  • NOTOHARA Kenji
    Department of Pathology, Okayama University Graduate School of Medicine and Dentistry
  • UEOKA Hiroshi
    Department of Hematology, Oncology and Respiratory Medicine Okayama University Graduate School of Medicine and Dentistry
  • TANIMOTO Mitsune
    Department of Hematology, Oncology and Respiratory Medicine Okayama University Graduate School of Medicine and Dentistry

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Abstract

We describe a 55-year-old man with advanced adenocarcinoma of the lung who received gefitinib (‘IRESSA’). After gefitinib administration for 7 months, computed tomography scan of the chest demonstrated diffuse ground glass opacity and he was suspected to have developed gefitinib-induced interstitial lung disease (ILD). However, transbronchial lung biopsy (TBLB) revealed tumor cells in the middle-size lung vessels. Afterwards, multiple infarctions of the brain, spleen and left kidney were detected. Then, he was considered to have developed systemic tumor emboli, a rare complication. The clinical presentation of this patient was difficult to discriminate from that of ILD, and TBLB was useful in the differential diagnosis.

Journal

  • Internal Medicine

    Internal Medicine 44 (9), 979-982, 2005

    The Japanese Society of Internal Medicine

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