[Etoposide-induced pneumonitis]

A 70-year-old man was given a diagnosis of small cell lung cancer because of the findings of examination of a specimen obtained by transbronchial lung biopsy from the rS4 a. He was treated with 2 courses of neoadjuvant chemotherapy (CBDCA, Etoposide) and underwent right middle lobectomy. He was then given 3 courses of adjuvant chemotherapy (CBDCA, Etoposide) as an inpatient and received oral etoposide (50 mg/day) as an outpatient. He was then admitted to our hospital because of dyspnea and fever. A chest-X-ray film showed reticulonodular shadows in both lung fields and blood gas analysis showed marked hypoxemia. A differential cell count of bronchoalveolar lavage fluid showed a high level of lymphocytes; and examination of a specimen obtained by transbronchial lung biopsy revealed edema of the alveolar walls, lymphocyte infiltration, and marked proliferation of type II alveolar epithelial cells. Administration of etoposide was stopped and steroid therapy was given. The symptoms, hypoxemia, and bilateral reticulonodular shadows resolved. The clinical course along with the findings from examination of bronchoalveolar lavage fluid and of the biopsy specimen, suggest that this patient had drug pneumonitis caused by oral etoposide.