Abstract
Objective. To demonstrate the characteristic clinical features of acute exacerbation of interstitial pneumonia (IP) associated with lung cancer after anti-cancer treatment. Methods. Consecutive 776 cases with lung cancer between June 1999 and April 2007 were retrospectively evaluated to clarify the clinicopathological characteristics of acute exacerbation of IP associated with lung cancer after anti-cancer treatment. Results. Among 776 cases of lung cancer, 39 cases (5%) had concomitant IP. Acute exacerbation of IP after treatment was found in 6 of the 39 cases (15%), and 4 cases (10%) died of respiratory failure. There were no significant differences in LDH, KL-6, SP-D, PaO2, %VC, or %DLco between the acute exacerbation group and the non-acute exacerbation group before anti-cancer treatment. Of the 6 cases with acute exacerbation of IP after treatment, exacerbation occurred after chemotherapy in 5 out of 24 cases (21%), and after surgical resection of the lung cancer in 1 out of 6 cases (17%). Among the 6 cases with acute exacerbation of IP, the subclassification of IP was IPF in 4 and collagen vascular disease-IP (CVD-IP) in 2. Among the 4 cases who died of respiratory failure after acute exacerbation of IP, the underlying systemic disease was IPF in 2 and CVD-IP in 2. Conclusion. Both IIPs and CVD-IP should go through the anti-cancer treatment, keeping the possibility of acute exacerbation of IP in mind.
