Chronic eosinophilic pneumonia after radiation therapy for breast cancer
Chronic eosinophilic pneumonia after radiation therapy for breast cancer
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DOI：
10.1183/09031936.03.00071303
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发表时间：
2004-01-01
影响因子：
24.3
通讯作者：
Cordier, JF
中科院分区：
文献类型：
--
作者：
Cottin, V;Frognier, R;Cordier, JF
本研究描述了5例女性乳腺癌患者在放疗后发生慢性嗜酸性粒细胞性肺炎的情况，平均年龄68岁（范围49-77），所有患者均有哮喘和/或过敏史。在嗜酸性粒细胞性肺炎发作时，所有患者都有症状。胸部X线片显示肺浸润，单侧和局限于照射肺的三名患者，和双侧。1例患者的肺部阴影为迁移性。所有患者的血嗜酸性粒细胞> 1.0 10（9.）L（-1）和/或支气管肺泡灌洗细胞分类计数嗜酸性粒细胞> 40%。放射治疗结束与嗜酸性粒细胞性肺炎发作之间的中位时间间隔为3.5个月（范围1-10）。所有患者均在口服皮质类固醇后迅速改善，无后遗症。两名患者在停药后复发。通过乳房放射治疗引发肺泡炎可能促进闭塞性细支气管炎机化性肺炎或慢性嗜酸性粒细胞性肺炎，后者取决于患者的遗传或获得性特征和/或可能触发T辅助细胞2型淋巴细胞反应的进一步刺激，特别是在哮喘或其他特应性表现的患者中。
The priming of bronchiolitis obliterans organising pneumonia by radiation therapy (RT) to the breast is now a well recognised syndrome.This study describes the occurrence of chronic eosinophilic pneumonia following RT after surgery for breast cancer in five female patients, with a mean age of 68 yrs (range 49-77).All patients had a history of asthma and/or allergy. At the onset of eosinophilic pneumonia, all patients were symptomatic. Chest radiograph showed pulmonary infiltrates, unilateral and limited to the irradiated lung in three patients, and bilateral in two. Pulmonary opacities were migratory in one patient. All patients had blood eosinophilia > 1.0 10(9.)L(-1) and/or eosinophilia > 40% at bronchoalveolar lavage differential cell count. The median time interval between the end of radiation therapy and the onset of eosinophilic pneumonia was 3.5 months (range 1-10). All patients rapidly improved with oral corticosteroids without sequelae. Relapse occurred in two patients after treatment withdrawal.Priming of alveolitis by radiation therapy to the breast might promote either bronchiolitis obliterans organising pneumonia or chronic eosinophilic pneumonia, with the latter depending on genetic or acquired characteristics of patients and/or further stimulation that may trigger a T-helper cell type 2 form of lymphocyte response, especially in patients with asthma or other atopic manifestations.