Annals of The Japanese Respiratory Society:A case of malignant pleural mesothelioma with pseudoprogression induced by immune checkpoint inhibitors

Vol.13 No.4 Table of Contents

Abstract

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Article in Japanese

Case Report

A case of malignant pleural mesothelioma with pseudoprogression induced by immune checkpoint inhibitors

Takanori Yamada^a,c Hideaki Yamakawa^a,c Chisa Uzuka^a Akiko Adachi^b Hidekazu Matsushima^a

^aDepartment of Respiratory Medicine, Saitama Red Cross Hospital
^bDepartment of Pathology, Saitama Red Cross Hospital
^cDepartment of Respiratory Medicine, Tokyo Jikei University Hospital

ABSTRACT

A 77-year-old man was diagnosed with epithelial malignant pleural mesothelioma and was started on primary treatment with nivolumab and ipilimumab. Before the second course of treatment, dyspnea occurred, accompanied by increased pleural effusion, and there was a possibility of disease progression. We suspected pseudoprogression and continued the treatment. Pleural fluid examination showed a clear increase in T-cell lymphocytes, confirming findings consistent with pseudoprogression. Thereafter, both the symptoms and imaging findings showed a trend toward improvement. There are few reports of pseudoprogression in malignant pleural mesothelioma. Pathologic evaluation of a cell block specimen of the pleural effusion was useful for differential diagnosis in this case.

KEYWORDS

Malignant pleural mesothelioma Pseudoprogression Nivolumab Ipilimumab

Received 8 Dec 2023 ／ Accepted 16 Apr 2024

AJRS, 13(4): 193-197, 2024

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