TWO CASES REPORT OF EOSINOPHLIC PNEUMONIA AFTER SURGERY FOR LUNG CANCER

Two patients with eosinophlic pneumonia after surgery for lung cancer are reported. Patient 1, a 69-year-old man, underwent a right lobectomy for primary lung cancer (squamous cell carcinoma) without idiopathic interstitial pneumonia. On the ninth postoperative day, the patient had fever and methicillin-resistant Staphylococcus aureus (VCM) was used. CT scan on the 12th postoperative day revealed diffuse reticular shadow in the both lungs. On the 30th postoperative day dyspnea and hypoxia developed. From 11 and 38 days, respectively, after the operation, acute eosinophlic pneumonia occurred on the nonoperated side and progressed. PaO2 was low and reticular shadows on chest X-ray film and a chest CT scan were increased. Eosinophilia in peripheral blood was not initially present in patient 1. Bronchoalveolar lavage (BAL) analysis demonstrated significant eosinophilia (20%) with no evidence of infection. Steroid pulse therapy was successful. Symptomatic remission and significant improvement in blood gas and chest shadows were attained. Patient 2, an 83-year-old man, was operated on for left lung cancer (adenocarcinoma). On the 30th postoperative day, cough and fever developed. Peripheral white blood cell count was 19, 620/μ1 and eosinophilic leukocyte was 65.5%. Chest x-ray film and a chest CT scan revealed interstitial shadow in the right upper lobe. Plednisolone therapy at a dose of 30mg/day was stated, with a favorable outcome. When minute interstitial shadow appears and increases on the non-operated lung after operation for lung cancer, we must suspect eosinophilic pneumonia and to give steroid pulse therapy.