A Case of Pneumocystis Pneumonia during Adjuvant Chemotherapy after Ileocecal Resection Diagnosed as Terminal Ileal Primary Malignant Lymphoma

Ryo Oono, Yoshihiro Ueda, Ken Yoshida, Kazuki Taniguchi, Makoto Nagahara, Shinya Ishimaru, Takao Ishida and Yoshiharu Hatano*

Department of Surgery and Department of Pathology*, Nakano General Hospital

Adjuvant chemotherapy with cyclophosphamide, vincristine, adriamycin, prednisolon (CHOP) was administered to a 79-year-old woman following ileocecal resection diagnosed as terminal primary malignant ileal lymphoma. After 2 cycles of CHOP, she was admitted for a severe nonproductive cough and high fever. X-ray imaging and computed tomography (CT) of the chest showed diffuse ground-glass bilateral opacities diagnosed as pneumocystis pneumonia (PCP) as deduced from markedly elevated serum beta-D-glucan. Following treatment with trimethoprim-sulfamethoxazole and corticosteroids, she recovered and her chest radiography became normal. PCP occurs most commonly in patients undergoing immunosuppressive therapy for cancer or organ transplantation and people with AIDS. These treatments should be started early in the course of the illness as side effects of adjuvant chemotherapy for cancer.

Key words
pneumocystis pneumonia, terminal malignant lymphoma, chemotherapy

Reprint requests
Ryo Oono Department of Surgery, Nakano General Hospital
4-59-16 Chuo, Nakano-ku, 164-8607 JAPAN

Accepted
May 30, 2007

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