Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Nivolumab-induced Acute Fibrinous and Organizing Pneumonia (AFOP)
Tsukasa IshiwataTakahiro EbataShunichiro IwasawaJun MatsushimaSatoshi OtaYukio NakataniKenji TsushimaYuji TadaKoichiro TatsumiYuichi Takiguchi
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JOURNALS OPEN ACCESS

2017 Volume 56 Issue 17 Pages 2311-2315

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Abstract

Although nivolumab is known to cause immune-related interstitial lung diseases (ILD), the detailed characteristics of ILD are still not fully understood. A 68-year-old man was treated with nivolumab because of unresectable sinonasal melanoma, he achieved a complete response soon after the initiation of the therapy and a complete response was thereafter maintained for 30 weeks until the patient experienced dyspnea of subacute onset. CT images revealed patchy infiltrates and ground-glass opacifications. The bronchoalveolar lavage fluid (BALF) contained elevated percentages of lymphocytes (53%) and neutrophils (30%). A transbronchial lung biopsy revealed intraalveolar fibrin balls without hyaline membranes, which was considered to be consistent with the pattern of acute fibrinous and organizing pneumonia (AFOP). This is the first report of AFOP induced by nivolumab.

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© 2017 by The Japanese Society of Internal Medicine
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