• Internal medicine · Apr 2023

    Case Reports

    A Case of Autoimmune Pulmonary Alveolar Proteinosis with Suspected Exacerbation after Osimertinib Administration for Lung Cancer.

    • Masafumi Shimoda, Haruyuki Ishii, Yoshiaki Tanaka, Kozo Morimoto, Tamiko Takemura, Teruaki Oka, Kozo Yoshimori, and Ken Ohta.
    • Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Japan.
    • Intern. Med. 2023 Apr 15; 62 (8): 120312061203-1206.

    AbstractA 46-year-old woman with lung cancer who received chemotherapy was admitted to our hospital for lower-lobe bilateral ground-glass opacity (GGO). GGO developed after the lung cancer diagnosis, deteriorated after the initiation of osimertinib, and incompletely decreased after interrupting osimertinib; therefore, flexible bronchoscopy was performed. Transbronchial lung biopsy histology and anti-granulocyte/macrophage colony-stimulating factor autoantibody positivity revealed autoimmune pulmonary alveolar proteinosis (aPAP) that did not require treatment. This rare case of aPAP comorbid with lung cancer suggested that using PAP findings to differentiate from drug-induced lung injury or lymphangitis is difficult and that osimertinib was suspected to exacerbate aPAP.

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