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

Shigeki UMEMURA; Daizo KISHINO; Masahiro TABATA; Katsuyuki KIURA; Katsuyuki HOTTA; Kenji NISHII; Yasushi TANIMOTO; Arihiko KANEHIRO; Kenji NOTOHARA; Hiroshi UEOKA; Mitsune TANIMOTO

doi:10.2169/internalmedicine.44.979

CASE REPORTS

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

Shigeki UMEMURA, Daizo KISHINO, Masahiro TABATA, Katsuyuki KIURA, Katsuyuki HOTTA, Kenji NISHII, Yasushi TANIMOTO, Arihiko KANEHIRO, Kenji NOTOHARA, Hiroshi UEOKA, Mitsune TANIMOTO

Author information

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

Keywords: NSCLC, tumor embolism, gefitinib, ground glass opacity, transbronchial lung biopsy

JOURNAL OPEN ACCESS

2005 Volume 44 Issue 9 Pages 979-982

DOI https://doi.org/10.2169/internalmedicine.44.979

Details

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.

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