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. 2012 Mar;72(3):318-22.
doi: 10.4046/trd.2012.72.3.318. Epub 2012 Mar 31.

A case of capecitabine-induced sarcoidosis

Shin Myung Kang  1 , Ji Yeon Baek, Bin Hwangbo, Hyae-Young Kim, Geon-Kook Lee, Hee Seok Lee
Affiliations

A case of capecitabine-induced sarcoidosis

Shin Myung Kang et al. Tuberc Respir Dis (Seoul). 2012 Mar.

Abstract

Sarcoidosis is an inflammatory disease involving multiple-organs with an unknown cause. The new onset of sarcoidosis associated with therapeutic agents has been observed in 3 clinical settings; tumor necrosis factor antagonists in autoimmune rheumatologic diseases, interferon alpha with or without ribavirin in patients with chronic hepatitis C or melanoma, and antineoplastic agent-associated sarcoidosis in patients with hematologic malignancies. Here, we report a female patient who developed sarcoidosis after capecitabine treatment as an adjuvant chemotherapy for sigmoid colon cancer. To our knowledge, this is the first report of a capecitabine-induced sarcoidosis.

Keywords: Capecitabine; Sarcoidosis; Sigmoid Neoplasms.

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Figures

Figure 1
Figure 1
Chest radiography prior to capecitabine chemotherapy (A) shows no abnormality. After chemotherapy (B), bilateral hilar adenopathies and parenchymal infiltrates in the left upper lung field are observed. Three months after the discontinuation of capecitabine (C), bilateral hilar adenopathies and parenchymal infiltrates are not observed.
Figure 2
Figure 2
There are no unusual findings in the lungs and mediastinum regarding the chest computed tomography (CT) taken before capecitabine chemotherapy (A, D). After the chemotherapy (B, E), subcarinal and hilar lymph nodes enlargement, beaded bronchovascular bundle, and multiple scattered tiny nodules are observed on the chest CT. Three months after the discontinuation of capecitabine (C, F), the CT shows no subcarinal or hilar lymph node enlargement, and a decrease in size and the number of tiny nodules compared with previous CT images.
Figure 3
Figure 3
There is no abnormal hypermetabolic lesion except in the sigmoid colon before capecitabine chemotherapy on positiron emission tomography-computed tomography scan (A). After the chemotherapy (B), multiple hypermetabolic lesions suggesting lymphadenopathies are observed in right supraclavicular, mediastinal, hilar, and retroperitoneal areas. A hypermetabolic lesion is also observed in the left upper lung field.
Figure 4
Figure 4
Microscopic finding of transbronchial lung biopsy specimens show multiple noncaseating granulomas (H&E stain; A, ×100; B, ×200).
See this image and copyright information in PMC

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