Lymphoproliferative Disorder in an Esophageal Cancer Patient Treated with Pembrolizumab

  • Matsumura Takashi
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Japan
  • Tsuchihashi Kenji
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Japan
  • Yamamoto Takeo
    Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Japan
  • Jinnouchi Fumiaki
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Japan
  • Kusano Wataru
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Japan
  • Kusumoto Yota
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Japan
  • Arimizu Kohei
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Japan
  • Ohmura Hirofumi
    Department of Comprehensive Oncology, Graduate School of Medical Sciences, Kyushu University, Japan
  • Kuma Yuki
    Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Japan
  • Moriyama Shohei
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Japan
  • Yamaguchi Kyoko
    Department of Medical Education, Graduate School of Medical Science, Kyushu University, Japan
  • Ito Mamoru
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Japan
  • Isobe Taichi
    Department of Comprehensive Oncology, Graduate School of Medical Sciences, Kyushu University, Japan
  • Ariyama Hiroshi
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Japan
  • Oda Yoshinao
    Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Japan
  • Akashi Koichi
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Japan
  • Baba Eishi
    Department of Comprehensive Oncology, Graduate School of Medical Sciences, Kyushu University, Japan

Description

<p>A 75-year-old man diagnosed with esophageal cancer and lung metastasis received a combination of fluorouracil, cisplatin, and pembrolizumab. During pembrolizumab maintenance therapy, lymphoproliferative lesions at the lips and mouth and multiple lymph node swellings appeared. Histologically, Epstein-Barr virus (EBV)-encoded RNA was positive, and EBV-DNA was detected in the blood. The patient was diagnosed with other iatrogenic immunodeficiency-associated lymph proliferative disorders (OIIA-LPDs) related to EBV activation induced by pembrolizumab. Rituximab was administered, resulting in the improvement of the OIIA-LPD. The emergence of an OIIA-LPD merits close attention in patients receiving immune checkpoint inhibitors. </p>

Journal

  • Internal Medicine

    Internal Medicine advpub (0), 2024

    The Japanese Society of Internal Medicine

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