Yonsei Med J.  2008 Feb;49(1):155-158.

Rituximab-CHOP Induced Interstitial Pneumonitis in Patients with Disseminated Extranodal Marginal Zone B Cell Lymphoma

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, Korea. brightree@lycos.co.kr
  • 2Department of Diagnostic Radiology, College of Medicine, Gyeongsang National University, Jinju, Korea.
  • 3Gyeongsang Institute of Health Science, Jinju, Korea.
  • 4Gyeongnam Regional Cancer Center, Jinju, Korea.

Abstract

A 69-year-old male was diagnosed in February 2004 with stage IV extranodal marginal zone B cell lymphoma involving the mediastinal nodes, lung parenchyma and bone marrow with high LDH. Shortness of breath developed following the 5th course of Rituximab-CHOP chemotherapy (cyclophosphamide, Vincristine, Doxorubicin, Prednisolone). Bronchoscopy guided transbronchial lung biopsy revealed interstitial thickening and type II pneumocyte activation, compatible with interstitial pneumonitis. After treatment with prednisolone a complete resolution of the dyspnea was observed. The patient was well on routine follow-up at the outpatient clinic, with no progression of lymphoma or interstitial pneumonitis.

Keyword

Interstitial pneumonitis; rituximab; lymphoma

MeSH Terms

Aged
Antibodies, Monoclonal/*adverse effects/*therapeutic use
Antineoplastic Combined Chemotherapy Protocols/*adverse effects/*therapeutic use
Biopsy
Cyclophosphamide/adverse effects/therapeutic use
Doxorubicin/adverse effects/therapeutic use
Humans
Lung Diseases, Interstitial/*chemically induced/*pathology/radiography/surgery
Lymphoma, B-Cell, Marginal Zone/*drug therapy
Male
Prednisone/adverse effects/therapeutic use
Tomography, X-Ray Computed
Vincristine/adverse effects/therapeutic use

Figure

  • Fig. 1 Computed tomography of the chest, showing new bilateral patchy ground-glass opacities.

  • Fig. 2 Transbronchial lung biopsy, showing interstitial thickening and type II pneumocyte activation (×200, hematoxylin and eosin).


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