Abstract
Background. Although many cases of organizing pneumonia (OP) after radiation therapy to a breast cancer has been reported, but no case of OP combined with pulmonary alveolar hemorrhage after radiation therapy for postoperative breast cancer has been reported. We reported the case of OP combined with pulmonary alveolar hemorrhage after radiotherapy for breast cancer. Case. A 63-year-old woman underwent conservation surgery for right breast cancer, and received radiation to the postoperative breast. About four months later, she developed general fatigue and cough. High-resolution CT of the chest showed infiltrative shadows outside the radiation field in the right lung field. Bronchoalveolar lavage fluid (BALF) was bloody, and transbronchial lung biopsy specimens revealed OP. We considered that the patient had OP combined with pulmonary alveolar hemorrhage after radiotherapy for breast cancer. After treatment with prednisolone, her clinical symptoms and radiologic findings resolved. During the course of tapering the dose of prednisolone, she suffered from relapse. Follow-up bronchoscopy showed bloody BALF with many hemosiderin-laden macrophages, which revealed pulmonary alveolar hemorrhage. Conclusion. We considered that this case was a case of OP after radiotherapy for breast cancer in which pulmonary alveolar hemorrhage had been confirmed at the both initial and relapse time. We reported the first case of OP after radiation therapy for postoperative breast cancer combined with pulmonary alveolar hemorrhage.
