{"title":"Successfully managed combined pulmonary fibrosis and emphysema in a lung large cell neuroendocrine carcinoma patient treated with pembrolizumab","authors":"Katsunori Kagohashi, Hiroaki Satoh","doi":"10.1111/crj.13327","DOIUrl":null,"url":null,"abstract":"To the Editor: A 75-year-old man was referred to our division because of an appearance of tumor in the left lobe of the liver. The patient had a smoking habit and was diagnosed as having combined pulmonary fibrosis and emphysema (CPFE) 9 years ago by a respiratory function test and chest CT (Figure 1A). Then, the patient visited our hospital regularly. Chest CT taken 8 years after the first visit, a nodule appeared in the right upper lobe of the lung. He underwent right upper lobectomy and mediastinal lymph node dissection. Pathologically, the tumor was diagnosed as stage IIB large cell neuroendocrine carcinoma (LCNEC). The expression of programmed death ligand 1 tumor proportion score of the resected specimens was 25%. No adjuvant chemotherapy was performed because the patient did not wish to receive it. Fluorodeoxyglucose (FDG)/ positron emission tomography-CT scan taken 1 year after the surgical resection, a tumor with FDG uptake in the left lobe of the liver was found (Figure 2A). Physical examination was unremarkable. His modified British Medical Research Council Scale was Grade 2. The arterial oxygen saturation (SpO2) was 97% in resting room air. Although liver metastatic lesion was asymptomatic, chemotherapy, immune checkpoint inhibitor, and combination of them were proposed. The risk of pulmonary toxicity of them was also repeatedly presented. As a result, the patient selected an immune checkpoint inhibitor therapy. Pembrolizumab (200 mg/day) was started with the schedule of administration once every 3 weeks. One week after the first administration of pembrolizumab, increase in","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2021-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/crj.13327","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Respiratory Journal","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/crj.13327","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 1
Abstract
To the Editor: A 75-year-old man was referred to our division because of an appearance of tumor in the left lobe of the liver. The patient had a smoking habit and was diagnosed as having combined pulmonary fibrosis and emphysema (CPFE) 9 years ago by a respiratory function test and chest CT (Figure 1A). Then, the patient visited our hospital regularly. Chest CT taken 8 years after the first visit, a nodule appeared in the right upper lobe of the lung. He underwent right upper lobectomy and mediastinal lymph node dissection. Pathologically, the tumor was diagnosed as stage IIB large cell neuroendocrine carcinoma (LCNEC). The expression of programmed death ligand 1 tumor proportion score of the resected specimens was 25%. No adjuvant chemotherapy was performed because the patient did not wish to receive it. Fluorodeoxyglucose (FDG)/ positron emission tomography-CT scan taken 1 year after the surgical resection, a tumor with FDG uptake in the left lobe of the liver was found (Figure 2A). Physical examination was unremarkable. His modified British Medical Research Council Scale was Grade 2. The arterial oxygen saturation (SpO2) was 97% in resting room air. Although liver metastatic lesion was asymptomatic, chemotherapy, immune checkpoint inhibitor, and combination of them were proposed. The risk of pulmonary toxicity of them was also repeatedly presented. As a result, the patient selected an immune checkpoint inhibitor therapy. Pembrolizumab (200 mg/day) was started with the schedule of administration once every 3 weeks. One week after the first administration of pembrolizumab, increase in
期刊介绍:
Overview
Effective with the 2016 volume, this journal will be published in an online-only format.
Aims and Scope
The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic.
We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including:
Asthma
Allergy
COPD
Non-invasive ventilation
Sleep related breathing disorders
Interstitial lung diseases
Lung cancer
Clinical genetics
Rhinitis
Airway and lung infection
Epidemiology
Pediatrics
CRJ provides a fast-track service for selected Phase II and Phase III trial studies.
Keywords
Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease,
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