PMC5852387_01
Nivolumab treatment timeline.
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Following various chemotherapeutic schemes and palliative radiotherapy, progressive disease persisted until February 2016(Fig. 1), when he was started on nivolumab at 3 mg/kg every 2 weeks. Three weeks later, the patient was readmitted due to worsening dyspnea, with bilateral lung infiltrates on chest CT (Fig. 1); he was immediately started on intravenous prednisolone at a dose of 3 mg/kg/day upon the assumption of pneumonitis.
Pulmonary fibrosis with focal lymphoplasmacytic chronic inflammation, suggestive of nivolumab-related pneumonitis.
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A CT-guided lung fine needle biopsy (FNB), performed five days later, disclosed pulmonary fibrosis with focal lymphoplasmacytic chronic inflammation, suggestive of nivolumab-related pneumonitis (Fig. 2); moreover, a few cells with enlarged nuclei were seen, one containing an intranuclear eosinophilic inclusion.