Herbal medicine-induced multiple pulmonary pseudotumors
Shin Takayama1,2,3, Tetsuya Akaishi1, Masakazu Hanagama4
1Department of Education and Support for Regional Medicine, Tohoku University School of Medicine, Sendai, Japan.
Journal of Family Medicine and Primary Care
|October 26, 2020
Summary
Japanese herbal medicines can cause rare lung nodules mimicking cancer. Discontinuation of Keishikajutsubuto led to nodule resolution, suggesting a herbal medicine side effect.
Area of Science:
- Pharmacology
- Pulmonology
- Oncology
Background:
- Japanese herbal medicines (HMs) are widely used but can cause adverse drug reactions (ADRs).
- Solid nodule formation is an uncommon ADR associated with HMs.
- Distinguishing HM-induced lung changes from malignancy is clinically significant.
Observation:
- A 63-year-old male developed multiple bilateral lung nodules after 4 weeks of Keishikajutsubuto, a Japanese herbal medicine.
- The patient presented with back pain, and the lung nodules appeared on chest radiograph and CT scan.
- Initial investigations, including blood tests and lung biopsy, were inconclusive for interstitial pneumonia or lung cancer.
Findings:
- Discontinuation of Keishikajutsubuto resulted in the complete resolution of lung nodules within three months.
- No interstitial pneumonia or other known ADRs were reported for Keishikajutsubuto previously.
- The observed lung nodules mimicked metastatic lung cancer on imaging.
Implications:
- Adverse drug reactions from Japanese herbal medicines should be considered in the differential diagnosis of patients presenting with multiple lung nodules.
- This case highlights the potential for certain HMs to cause radiographically apparent lung changes that can be mistaken for malignancy.
- Further investigation into the potential for Keishikajutsubuto to induce lung nodule formation is warranted.
