Reactions 1680, p318 - 2 Dec 2017
Lung injury: case report
A 74-year-old man developed lung injury during treatment
with tamoxifen [route not stated].
The man was diagnosed with stage IIA papillotubular
carcinoma in the right breast and underwent surgery for its
treatment in December 2015. He received adjuvant therapy
with tamoxifen 20 mg/day after the surgery. He presented to
hospital with complaints of mild cough after 90 days. A CT
scan of the chest showed mild ground glass opacification in
the lower lobe of the right lung. Drug-induced lung injury or
infectious pneumonia was suspected.
The man’s tamoxifen therapy was discontinued, following
which improvement was observed in the chest CT scan.
Tamoxifen could not be confirmed as the cause of the cough.
Hence, tamoxifen therapy was re-initiated. He presented after
two months with the complaints of cough and dyspnoea on
exertion. On admission, his respiratory rate was 16 bpm, and
oxygen saturation was 93% at room air. Fine crackles in the
right lower lung fields were demonstrated by a physical
examination. His serum CRP level 0.06 mg/dL. Reticular
shadows were observed at the right lower zone in a chest x-
ray. Mosaic perfusion and ground glass opacification were
observed in the right lower zone in a chest CT scan. However,
architectural distortion, consolidation or traction
bronchiectasis was not observed. Bronchoalveolar lavage was
performed and the bronchoalveolar fluid (BALF) revealed
elevated lymphocytes and total cell count. His BALF culture
was negative and BALF cytology was class I. Interstitial fibrosis,
which was revealed by trans-bronchial biopsy, was associated
with the proliferation of fibroblasts and lymphocytic
infiltration. A drug lymphocyte stimulation test of the
peripheral blood was positive for tamoxifen. A diagnosis of
tamoxifen induced lung injury was made. His therapy with
tamoxifen was discontinued. However, his dyspnoea on
exertion aggravated. No improvement in the chest radiography
findings was observed. Oxygen saturation on room air
decreased. As a result, he received treatment with
prednisolone, following which a dramatic improvement in the
chest radiography findings was observed.
Author comment: "We reported a case of tamoxifen-
induced lung injury in a patient who had undergone surgery
for the treatment of breast cancer."
Etori S, et al. Tamoxifen-induced lung injury. Internal Medicine 56: 2903-2906,
No. 21, 2017. Available from: URL: http://doi.org/10.2169/
internalmedicine.8649-16 - Japan
Reactions 2 Dec 2017 No. 16800114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved