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Miliary lung disease after intravesical bacillus Calmette-Guérin immunotherapy
R M Jasmer1, M J McCowin, W R Webb
1Department of Medicine, University of California, San Francisco Medical Center 94143, USA.
Insights
Systemic illness developed in a patient undergoing intravesical bacillus Calmette-Guérin (BCG) immunotherapy for bladder cancer. Chest CT revealed miliary nodules, suggesting BCG-induced lung disease, possibly from hypersensitivity or infection.
Area of Science:
- Oncology
- Immunology
- Pulmonology
Background:
- Intravesical bacillus Calmette-Guérin (BCG) is a standard immunotherapy for bladder cancer.
- Systemic complications from intravesical BCG are rare but can be severe.
- Pulmonary involvement is a potential, albeit uncommon, manifestation.
Abstract:
Clinical and radiologic findings in a 73-year-old man who developed a systemic illness while receiving intravesical bacillus Calmette-Guérin (BCG) immunotherapy for bladder cancer are presented. Thin-section chest computed tomographic findings included a diffuse pattern of small nodules consistent with miliary disease. Potential mechanisms explaining the pulmonary disease resulting from intravesical BCG treatment include a hypersensitivity reaction or actual BCG infection of the lungs.