A case of lung squamous cell carcinoma with long-term anti-tumor maintenance after the discontinuation of nivolumab due to tuberculous pericarditis
Naohiko Ogawa Taisuke Isono Mayuko Tani Masaru Nishitsuji Koichi Nishi
Department of Respiratory Medicine, Ishikawa Prefectural Central Hospital
A 69-year-old woman was diagnosed as having a Stage ⅣA (cT4N3M1a) lung squamous cell carcinoma. The patient developed dyspnea on exertion after 23 courses of nivolumab. Her contrast-enhanced computed tomography and echocardiography revealed cardiac tamponade. Pericardiocentesis was performed to palliate the symptom and detect the cause of the pericardial effusion. Mycobacterium tuberculosis was cultured, and no malignant cells were detected from the pericardial fluid. She was diagnosed with tuberculous pericarditis. Nivolumab was discontinued, and anti-tuberculous therapy was started. She maintained a partial response for more than 14 months after cessation of nivolumab. This case suggests that development of tuberculous pericarditis during immune checkpoint therapy remains a rare phenomenon but should be kept in mind when pericardial effusion increases.
Nivolumab Immune checkpoint inhibitor (ICI) Lung squamous cell carcinoma Tuberculous pericarditis
Received 7 Oct 2019 / Accepted 23 Jan 2020
AJRS, 9(3): 174-177, 2020