Korean J Radiol.  2014 Apr;15(2):300-304. 10.3348/kjr.2014.15.2.300.

Progressive Multiple Cystic Changes in Both Lungs in a Patient Treated with Gefitinib for Lung Adenocarcinoma with Multiple Lung Metastases

• Ryu YJ
• Chun EM
• Lee SN
• Shim SS

• KMID: 1705587
• DOI: http://doi.org/10.3348/kjr.2014.15.2.300

Abstract

Gefitinib is regarded as a relatively safe agent for the treatment of an advanced non-small cell lung cancer (NSCLC). Pulmonary toxicity such as interstitial lung disease associated with gefitinib is uncommon with an estimated all time incidence around 1% worldwide. Moreover, a case of gefitinib associated with pulmonary cystic changes has not been reported yet. In this report we present a case of progressive multiple air cystic changes in both lungs in a patient with NSCLC and intrapulmonary metastases who underwent a gefitinib therapy.

Keyword

Gefitinib; Non-small cell lung cancer; Cystic change

MeSH Terms

Antineoplastic Agents/*adverse effects
Brain Neoplasms/secondary
Carcinoma, Non-Small-Cell Lung/*drug therapy/secondary
Cysts/*chemically induced
Female
Humans
Lung/pathology
Lung Diseases/*chemically induced
Lung Diseases, Interstitial
Lung Neoplasms/*drug therapy
Middle Aged
Quinazolines/*adverse effects
Antineoplastic Agents
Quinazolines

Figure

• 

  Fig. 1 Lung adenocarcinoma in 56-year-old woman after gefitinib treatment. A. Lung window of transaxial enhanced CT (5.0-mm collimation) scan obtained at time point of pre-medication and 1 month, 3 months, 7 months, 9 months, and 13 months after initiation of gefitinib treatment. Irregular defined oval shaped 3.2 cm sized mass in right upper lobe with multiple ill-defined nodules of both lungs was gradually decreased in size after use of gefitinib on follow-up chest CT scan in contrast to gradual progression of cystic changes in both lungs. Some cystic lesions are continuously increased in size on follow-up scans during treatment with gefitinib. B. Coronal fluorodeoxyglucose (FDG) positron emission tomography scan obtained after 12 months of treatment demonstrates lesion of markedly increased FDG uptake (standardized uptake value = 5.2, representing primary malignancy) (arrow) without adjacent or distant significant FDG uptake.

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