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CASE REPORT article

Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1496693
This article is part of the Research Topic Community Series in Reducing Adverse Effects of Cancer Immunotherapy: Volume III View all articles

Diffuse Panbronchiolitis as a Rare Complication of Thymectomy and Radiation Therapy in a Patient with Thymoma: A Case Report

Provisionally accepted
Ye Lu Ye Lu Qi Qi Qi Qi *Dan Qu Dan Qu *Yu Chen Yu Chen *
  • Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China

The final, formatted version of the article will be published soon.

    Background: Diffuse panbronchiolitis (DPB) is an uncommon respiratory disorder characterized by the presence of respiratory bronchiolitis and persistent inflammation in adjacent tissues, which can be effectively treated with early diagnosis and intervention. DPB is a rare complication associated with thymoma that remains poorly understood, especially when it occurs in conjunction with acquired cellular immune deficiency. Case Presentation: We present a case of DPB in a patient with thymoma following thymectomy and radiation therapy. A 47-year-old Chinese man underwent thymectomy due to the presence of a mediastinal mass, and pathological examination confirmed a type B2 thymoma. He also underwent 25 sessions of radiation therapy. The patient's respiratory symptoms, including cough, expectoration, and shortness of breath, worsened significantly after radiation treatment. Immune dysfunction, marked by CD4+ T cell immunodeficiency with normal immunoglobulin levels, was observed. Chest computed tomography revealed diffuse nodules with tree-in-bud signs and new consolidation within the irradiated area, leading to a diagnosis of combined DPB and radiation pneumonitis. The patient's symptoms and lung imaging findings significantly improved after the initiation of low-dose oral azithromycin for DPB and low-dose glucocorticoid therapy for radiation pneumonitis. Conclusions: Clinicians should consider DPB in patients with thymoma and cellular immunodeficiency. Both thymectomy and radiation therapy can contribute to the development of DPB. Early treatment with macrolides can improve patient prognosis.

    Keywords: Diffuse panbronchiolitis, Thymoma, Cellular immunodeficiency, Radiation, case report

    Received: 15 Sep 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Lu, Qi, Qu and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Qi Qi, Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
    Dan Qu, Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
    Yu Chen, Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.