1.Hashimoto's Thyroiditis Presenting With Recurrent Massive Pleural Effusion Suggestive of Lymphocytic Interstitial Pneumonitis
Endah Pratamaningtias ; Nyoman Satvika Dharma Yudha
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):106-
Introduction:
Hashimoto's thyroiditis is a common autoimmune thyroid
disease; however, pulmonary involvement is a rare
manifestation. Lymphocytic interstitial pneumonitis is
commonly associated with autoimmune diseases, but its
association with Hashimoto's thyroiditis remains poorly
understood.
Case:
A 63-year-old male with prior diagnosis of Hashimoto's
thyroiditis presented with recurrent massive pleural
effusion and progressive dyspnea. He also experienced
fatigue, cold intolerance, and constipation. Physical
examination revealed facial puffiness, diffuse goiter, and
dry skin. Thyroid function tests performed 6 months before
admission confirmed overt hypothyroidism (thyroidstimulating hormone [TSH] 80.30 µIU/mL, free thyroxine
4 [FT4] 0.46 ng/dL). One month prior to admission,
laboratory findings showed subclinical hypothyroidism
(TSH 9.09 µIU/mL, FT4 1.42 ng/dL). Despite levothyroxine
treatment TSH levels remained elevated at 21.8 µIU/mL
during admission. Anti-thyroid peroxidase antibodies were
positive (13.95 IU/mL). Repeated thoracentesis revealed
exudative pleural effusion with lymphocytic predominance
and no evidence of malignancy in cytological examination.
Infectious etiologies and malignancy were ruled out.
Thyroid ultrasonography demonstrated diffuse hypoechoic
enlargement of the thyroid gland. Chest radiography
showed massive unilateral pleural effusion, while thoracic
computed tomography revealed ground-glass opacities
with a reticulogranular pattern and interlobular septal thickening, accompanied by multiple thin-walled cysts,
highly suggestive of lymphocytic interstitial pneumonitis.
Thyroid immunohistochemical analysis was performed
(CD 20, CD 3, CD 10, CD 138, Ki 67, BCL 2, BCL 6,
Thyroglobulin, MUM 1, Cyclin D1), consistent with
lymphocytic thyroiditis. Significant clinical and laboratory
improvement was achieved after combined treatment with
levothyroxine and corticosteroid.
Conclusion
This case underscores the importance of considering
autoimmune-related lymphocytic interstitial pneumonitis
in patients with Hashimoto's thyroiditis who present with
unexplained recurrent pleural effusion after exclusion of
more common etiologies, such as infection and malignancy.
Early recognition may lead to favorable improvement.
Lung Diseases, Interstitial
;
Pleural Effusion
;
Thyroiditis
2.Research Progress of Anti-lung Cancer Drug-related Interstitial Lung Disease.
Chinese Journal of Lung Cancer 2025;28(4):309-318
Lung cancer is the cancer with the highest incidence and mortality rate worldwide. In addition to the diversified treatment and prolonged lifespan in view of the development of medical technology, the side effect of medicine should not be ignored. Drug-induced interstitial lung disease (DI-ILD) is also commonly encountered during this process, and ILD triggered by the treatment of lung cancer characterized by the inflammation and scarring of lung tissue after the antitumor treatment in lung cancer leads to a poor prognosis and high mortality. The diagnosis and treatment of ILD caused by anti-lung cancer agents remains challenging in clinical settings and requires joint efforts from multidisciplinary team (MDT). This review systematically updates the epidemiology, molecular pathogenesis, genomics/genetics study, diagnosis and treatment of ILD related to anti-lung cancer agents. By the integration of the latest evidences, the paper offers clinical work references for early diagnosis of ILD related to anti-lung cancer agents to enhance the survival and quality of life of the lung cancer patients.
.
Humans
;
Lung Diseases, Interstitial/therapy*
;
Lung Neoplasms/drug therapy*
;
Antineoplastic Agents/therapeutic use*
3.Interstitial Lung Disease With CA19-9 Elevation After Oxaliplatin and Capecitabine Adjuvant Therapy for Ileocecal Carcinoma:Report of One Case.
Wen-Jing YANG ; Guo-Wang YANG ; Ying LI ; Hao WANG ; Lin YANG ; Wei-Ru XU
Acta Academiae Medicinae Sinicae 2025;47(4):660-665
Both carcinoembryonic antigen and CA19-9 are considered as predictive markers of intestinal cancer recurrence and metastasis.In addition,CA19-9 elevation is considered as a predictive marker of connective tissue disease-related interstitial lung disease.The incidence of oxaliplatin and capecitabine-associated interstitial lung disease is low,and there is no report about CA19-9 as a predictive marker of oxaliplatin and capecitabine-associated interstitial lung disease.This paper reports a case of interstitial lung disease with CA19-9 elevation caused by oxaliplatin and capecitabine adjuvant therapy for ileocecal carcinoma.The change trend of serum carcinoembryonic antigen in this patient was consistent with tumor recurrence and metastasis,and that of serum CA19-9 was consistent with the severity of interstitial lung disease.Therefore,CA19-9 elevation after intestinal cancer surgery does not necessarily indicate the tumor recurrence and metastasis,and attention should be paid to the possibility of oxaliplatin and capecitabine-associated interstitial lung disease.
Humans
;
CA-19-9 Antigen/blood*
;
Capecitabine
;
Cecal Neoplasms/drug therapy*
;
Chemotherapy, Adjuvant
;
Deoxycytidine/administration & dosage*
;
Fluorouracil/administration & dosage*
;
Lung Diseases, Interstitial/blood*
;
Organoplatinum Compounds/administration & dosage*
;
Oxaliplatin
4.Cancer therapy-related interstitial lung disease.
Chengzhi ZHOU ; Haiyi DENG ; Yilin YANG ; Fei WANG ; Xinqing LIN ; Ming LIU ; Xiaohong XIE ; Tao LUAN ; Nanshan ZHONG
Chinese Medical Journal 2025;138(3):264-277
With the increasing utilization of cancer therapy, the incidence of lung injury associated with these treatments continues to rise. The recognition of pulmonary toxicity related to cancer therapy has become increasingly critical, for which interstitial lung disease (ILD) is a common cause of mortality. Cancer therapy-related ILD (CT-ILD) can result from a variety of treatments including chemotherapy, targeted therapy, immune checkpoint inhibitors, antibody-drug conjugates, and radiotherapy. CT-ILD may progress rapidly and even be life-threatening; therefore, prompt diagnosis and timely treatment are crucial for effective management. This review aims to provide valuable information on the risk factors associated with CT-ILD; elucidate its underlying mechanisms; discuss its clinical features, imaging, and histological manifestations; and emphasize the clinical-related views of its diagnosis. In addition, this review provides an overview of grading, typing, and staging treatment strategies used for the management of CT-ILD.
Humans
;
Lung Diseases, Interstitial/diagnosis*
;
Neoplasms/therapy*
;
Risk Factors
;
Immune Checkpoint Inhibitors/adverse effects*
;
Antineoplastic Agents/therapeutic use*
5.Prevalence of diffuse parenchymal lung disease patterns on chest x-ray and reported respiratory symptoms among salon hairdressers in the National Capital Region: An analytical crosssectional study
Kristine Joy V. de Leon ; Jose Ronilo Juangco
Health Sciences Journal 2024;13(2):69-78
INTRODUCTION:
Exposure to chemical agents in salon products, such as ammonia and formaldehyde, poses significant respiratory health risks for hairdressers. This study aimed to assess the prevalence of Diffuse Parenchymal Lung Disease Patterns (DPLD) observed in chest X-rays of hairdressers in the National Capital Region and to document their reported respiratory symptoms.
METHODS:
An analytical, cross-sectional study was conducted involving 100 hairdressers who underwent plain chest X ray examinations to identify any of the 12 recognized DPLD patterns. Participants also accomplished a self administered questionnaire detailing their demographic information, working conditions, health histories and current respiratory symptoms.
RESULTS:
Thirty nine percent of participants showed DPLD patterns on chest X-rays, primarily fine reticular opacities (69.23%) and coarse reticular opacities (25.64%). Positive associations (RR>1) were linked to over five years of work, lack of PPE, daily exposure to hair iron steam, respiratory symptoms, and salon vapor exposure of exceeding five hours daily. Symptoms reported included shortness of breath (27%) and throat irritation (15%). Logistic regression confirmed a significant link between DPLD and positive respiratory symptoms.
CONCLUSION
This study highlights the risk of structural lung abnormalities and respiratory symptoms among hairdressers, emphasizing the need for improved workplace safety, consistent PPE use and routine medical screenings to reduce occupational health risks.
Human
;
Lung diseases, interstitial
7.A concise review of diagnosis and evaluation of interstitial lung abnormalities.
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(5):396-400
Interstitial lung abnormalities (ILAs) refer to the subtle or mild signs of ILAs pulmonary parenchyma on chest HRCT scans, which are not yet sufficient to diagnose a certain interstitial lung disease, may be potentially compatible an early stage of the diseases. The signs of ILAs usually includes ground-glass opacities, reticular abnormakicies, honeycombing, traction bronchiectasis or non-emphysematous cysts. This article reviews the research progreses in the definition and classification, risk factors, prognosis, comorbidities and management of ILAs in combination with domestic and foreign literatures.
Humans
;
Lung/diagnostic imaging*
;
Tomography, X-Ray Computed
;
Lung Diseases, Interstitial/diagnosis*
;
Prognosis
;
Diagnosis, Differential
8.A case of interstitial lung and liver disease caused by MARS1 gene mutation.
Wen-Jing PENG ; Yan ZHU ; Lai-Shuan WANG ; Wei LU ; Lin YANG ; Li ZHU
Chinese Journal of Contemporary Pediatrics 2023;25(11):1186-1190
The patient is a female infant, 4 months and 9 days old, who was admitted to the hospital due to recurrent fever, cough, and hepatomegaly for over a month. The patient was a healthy full-term infant with a normal birth history. At 2 months and 22 days after birth, she developed recurrent fever, cough, and respiratory distress. Chest imaging revealed diffuse bilateral lung lesions, and fiberoptic bronchoscopy showed interstitial changes in both lungs. These suggested the presence of interstitial lung disease. The patient also presented with hepatomegaly, anemia, hyperlipidemia, hypothyroidism, and malnutrition. Genetic testing indicated compound heterozygous variations in the MARS1 gene. This mutation can cause interstitial lung and liver disease, which is a severe rare disorder that typically manifests in infancy or early childhood. It is inherited in an autosomal recessive manner and characterized by early-onset respiratory insufficiency and liver disease in infants or young children. Since its first reported case in 2013, as of June 2023, only 38 related cases have been reported worldwide. This article reports the multidisciplinary diagnosis and treatment of interstitial lung and liver disease in an infant caused by MARS1 gene mutation.
Female
;
Humans
;
Infant
;
Cough
;
Hepatomegaly/pathology*
;
Liver Diseases
;
Lung/pathology*
;
Lung Diseases, Interstitial/pathology*
;
Mutation
9.A non-small cell lung carcinoma patient responded to crizotinib therapy after alectinib-induced interstitial lung disease.
Wenjia SUN ; Jing ZHENG ; Jianya ZHOU ; Jianying ZHOU
Journal of Zhejiang University. Medical sciences 2023;52(5):583-587
A 54-year-old, non-smoking woman was diagnosed as stage ⅣB adenocarcinoma with widespread bone metastasis (cT4N2M1c) in the First Affiliated Hospital, Zhejiang University School of Medicine. Immunohistochemistry result showed the presence of anaplastic lymphoma kinase (ALK) gene rearrangement; next-generation sequencing (NGS) indicated EML4-ALK fusion (E6:A20) with concurrent CCDC148-ALK (C1:A20), PKDCC-ALK (Pintergenic:A20)and VIT-ALK (V15:A20) fusions. After 32 weeks of alectinib treatment, the patient complained cough and exertional chest distress but had no sign of infection. Computed tomography (CT) showed bilateral diffuse ground glass opacities, suggesting a diagnosis of alectinib-related interstitial lung disease (ILD). Following corticosteroid treatment and discontinuation of alectinib, clinical presentations and CT scan gradually improved, but the primary lung lesions enlarged during the regular follow-up. The administration of crizotinib was then initiated and the disease was stable for 25 months without recurrence of primary lung lesions and ILD.
Female
;
Humans
;
Middle Aged
;
Carcinoma, Non-Small-Cell Lung/drug therapy*
;
Crizotinib/therapeutic use*
;
Lung Neoplasms/drug therapy*
;
Anaplastic Lymphoma Kinase/therapeutic use*
;
Lung Diseases, Interstitial/diagnosis*
10.Research progress on the role and mechanism of 5-hydroxytryptamine and M2 macrophages in pulmonary interstitial fibrosis.
Yiming DENG ; Changwen DENG ; Xiaoping ZHU
Chinese Critical Care Medicine 2023;35(9):1004-1008
Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease, the cause is not yet clear. Pathological manifestations are abnormal repair changes resulting from sustained lung injury. Macrophages have been identified as playing a key role in IPF pathogenesis. In different local microenvironments, macrophages can exhibit either classically activated (M1) or alternately activated (M2) phenotypes. M1 plays a key role in promoting inflammatory response and is involved in the process of causing alveolar tissue injury. M2 is involved in wound healing and stopping lung inflammation. Previous studies have shown that activation of 5-hydroxytryptamine (5-HT) signaling is enhanced in pulmonary fibrosis and that 5-HT receptors play an important role in the observed pro-fibrotic effects. As a multifunctional signaling molecule, 5-HT is closely related to lung macrophage polarization, early lung tissue injury, abnormal proliferation and repair, and late extracellular matrix (ECM) deposition. This article reviewed the role of 5-HT and M2 macrophages in the pathogenesis of IPF and the possible regulatory mechanism of 5-HT, in order to provide a reference for further research.
Humans
;
Serotonin
;
Macrophages
;
Lung Diseases, Interstitial/pathology*
;
Lung/pathology*
;
Idiopathic Pulmonary Fibrosis
;
Fibrosis


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