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Nodules, nodes and non-functioning macrophages: A risk with ibrutinib therapy
Peter Melville1, Farheena Mohammed1, Chris RuiWen Kuo1
1Department of Respiratory Medicine, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK.
Abstract:
We describe the case of a 70-year-old never smoker with chronic lymphocytic leukaemia, treated with single agent ibrutinib therapy. Chest imaging noted nodular change and mediastinal lymphadenopathy, which showed avid uptake on positron emission tomography and guided subsequent biopsies (bronchoscopy using endobronchial ultrasound, mediastinoscopy). Despite negative aspergillus blood immunology tests, he was found to have invasive aspergillosis, which is a known risk with ibrutinib therapy. He has since been successfully treated with antifungal therapy.
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