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Case Reports in Oncological Medicine
Volume 2017 (2017), Article ID 5640186, 4 pages
https://doi.org/10.1155/2017/5640186
Case Report

A Patient with Non-Hodgkin Lymphoma and Nonspecific Interstitial Pneumonia during Ibrutinib Therapy

1Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany
2Drug Commission of the German Medical Association, Herbert-Lewin-Platz 1, Berlin, Germany
3Department of Radiology, HELIOS Klinikum Emil von Behring, Berlin, Germany
4Diagnostic Radiology, Thoracic Imaging, Bismarckstr 45-47, Berlin, Germany
5Institute of Pathology, HELIOS Klinikum Emil von Behring, Berlin, Germany
6Onkologie Seestrasse, Seestr. 64, 13347 Berlin, Germany

Correspondence should be addressed to Torsten T. Bauer

Received 26 June 2017; Revised 18 September 2017; Accepted 4 October 2017; Published 10 November 2017

Academic Editor: Kaiser Jamil

Copyright © 2017 Sven Jungmann et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We present a 74-year-old male with nonspecific interstitial pneumonia (NSIP) during treatment with ibrutinib for mantle cell lymphoma. Previously, the patient had received six cycles of bendamustine and rituximab and six cycles of R-CHOP, followed by rituximab maintenance therapy. Respiratory tract complications of ibrutinib other than infectious pneumonia have not been mentioned in larger trials, but individual case reports hinted to a possible association with the development of pneumonitis. In our patient, the onset of alveolitis that progressed towards NSIP together with the onset of ibrutinib treatment suggests causality. One week after ibrutinib was discontinued, nasal symptoms resolved first. A follow-up CT showed a reduction in the reticular hyperdensities and ground-glass opacities, suggestive of restitution of the lung disease. To our knowledge, this is the first case showing a strong link between ibrutinib and interstitial lung disease, strengthening a previous report on subacute pneumonitis. Our findings have clinical implications because pulmonary side effects were reversible at this early stage. We, therefore, suggest close monitoring for respiratory side effects in patients receiving ibrutinib.