乳癌悪性胸水に対するOK-432胸膜癒着術後の間質性肺疾患-症例報告

[Interstitial Lung Disease after OK-432 Pleurodesis for Malignant Pleural Effusion in Breast Cancer-A Case Report].

抄録

患者は42歳の女性であった。右胸壁再発乳癌（ER(+, 10-15%)、PgR(-)、HER2(-)）に対してcapecitabine療法を4コース施行後、右胸水増加に対してOK-432を用いた胸膜癒着術を施行した。胸膜癒着術後12日目に右肺にびまん性の浸潤影、両肺にすりガラス状の影が認められ、薬剤性肺障害と診断された。プレドニゾロン1mg/kg投与約3週間後に肺障害の改善傾向が認められたが、乳癌の進行により死亡した。胸膜癒着術による薬剤性肺障害は、化学療法の再開を遅らせる危険性がある。この症例について、文献のレビューを交えて報告する。

The patient was a 42-year-old woman. After 4 courses of capecitabine therapy for right chest wall recurrence of breast cancer, ER(+, 10-15%), PgR(-), HER2(-), she underwent pleurodesis using OK-432 for increased right pleural effusion. On the 12th day after pleurodesis diffuse infiltrative shadows in the right lung, and frosted shadows in both lungs, were observed, and she was diagnosed with drug-induced lung injury. About 3 weeks after administration of prednisolone 1 mg/ kg a tendency for improvement in lung injury was observed, but the patient died of breast cancer progression. Drug- induced lung injury by pleurodesis carries the risk of delaying resumption of chemotherapy. We report this case with a review of the literature.