PMC6948310_01
Changes in chest X-ray images. Before treatment with nivolumab (a), at the onset of CIP (b), 1 week after the onset of CIP (c), 2 weeks after the onset of CIP (d), 1 month after the onset of CIP (e), 2 months after the onset of CIP (f), 3 months after the onset of CIP (g), and 6 months after the onset of CIP (h). The relapsed lung tumor is indicated by the arrows. CIP: checkpoint inhibitor pneumonitis.
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fig1
On the first day of 5 cycles of nivolumab, a chest CT examination revealed a reticular pattern and ground-glass attenuation with a shrinking lung mass in the left upper lobe (Figures 1(b) and 2(b)). Although she remained asymptomatic, her chest X-ray and CT images revealed an increasing interstitial shadow similar in appearance to that of a cryptogenic organizing pneumonia pattern until 2 months after the discontinuation of nivolumab (Figures 1(c)-1(f) and 2(c)). However, three months thereafter, the interstitial shadow began to disappear on the chest X-ray and CT images (Figures 1(g) and 2(d)), despite a lack of prednisone treatment. After 6 months, almost all the interstitial shadow had disappeared and the lung mass was continuing to shrink in size (Figures 1(h) and 2(e)).