Tuberc Respir Dis.  2009 Sep;67(3):234-238.

A Case of Henoch-Schonlein Purpura Developed during Treatment of Lung Cancer

• Kang MS
• Noh GY
• Jang YJ
• Cho SY
• Rhim KJ
• Noh HS
• Kim HR
• Kim CH
• Lee JC

Abstract

Henoch-Schonlein Purpura (HSP) is a systemic vasculitis involving small vessels with the deposition of immune complexes containing IgA and C3, which is characterized by associated skin, joint, renal, and gastrointestinal manifestations. Although there were several causes such as autoimmunity, infection, and drugs, it also can be presented as a form of vasculitidies associated with malignancies. We report a case of HSP developed during treatment for non-small cell lung cancer in a 66-year-old man. Multiple purpuric skin lesions occurred in both legs after the first cycle of chemotherapy, which was diagnosed as HSP by clinical and pathologic examinations. Due to the itching sensation, topical steroid was applied and the patient was improved 3 weeks later without a scheduled change in chemotherapy.

Keyword

Lung neoplasms; Henoch-Schonlein purpura; Vasculitis

MeSH Terms

Aged
Antigen-Antibody Complex
Autoimmunity
Carcinoma, Non-Small-Cell Lung
Humans
Immunoglobulin A
Joints
Leg
Lung
Lung Neoplasms
Pruritus
Purpura, Schoenlein-Henoch
Sensation
Skin
Systemic Vasculitis
Vasculitis
Antigen-Antibody Complex
Immunoglobulin A

Figure

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  Figure 1 CT scan of the chest at the diagnosis of Lung cancer shows that 2.5 cm sized lung mass is located in LUL (arrow) with paratracheal, subcarinal and AP window lymphadenopathy (arrowhead).

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  Figure 2 (A) Multiple purpuric skin lesions are presented on both lower legs at the diagnosis of Henoch-Schönlein purpura. (B) Previous purpuric skin lesions are mostly disappeared after the application of topical steroid.

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  Figure 3 Chest PA taken at the diagnosis of Henoch-Schönlein purpura shows an unchanged lung nodule (arrow) in LUL field.

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  Figure 4 (A) Microscopic finding presents the leukocytoclastic vasculitis with infiltrative neutrophils and lymphocytes in the superficial dermis (H&E stain, ×100). (B) Neutrophils and lymphocytes infiltrate into vascular wall with swollen endothelium under high microscopic field (H&E stain, ×400).

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