Nivolumab-induced systemic lymphadenopathy occurring during treatment of malignant melanoma: a case report.
Tomoyo KuboAkihisa HinoKentaro FukushimaYoshimitsu ShimomuraMasako KurashigeShinsuke KusakabeYasuhiro NagateJiro FujitaTakafumi YokotaHisashi KatoHirohiko ShibayamaAtsushi TanemuraNaoki HosenPublished in: International journal of hematology (2022)
Nivolumab is an anti-programmed cell death protein 1 monoclonal antibody that exhibits significant efficacy in treating melanoma and other malignancies. However, various nivolumab-induced immune-related adverse events (irAEs) have been reported, and differentiating irAEs from tumor progression is sometimes difficult. Here, we report a case of reactive lymphadenopathy occurring after treatment with nivolumab. A 56-year-old man with stage IIIC melanoma received adjuvant therapy with nivolumab after wide local excision. He developed systemic lymphadenopathy and autoimmune hemolytic anemia 1 month after receiving seven cycles of nivolumab. Pathological analysis of a cervical lymph node biopsy specimen revealed no metastatic lesion or any other malignancy, including lymphoma. Thus, the patient was diagnosed with nivolumab-induced reactive lymphadenopathy. Systemic corticosteroids were administered to reduce hemolysis, which led to the resolution of lymphadenopathy. When progressive lymphadenopathy is observed in a patient who received immune checkpoint inhibitor therapy, reactive lymphadenopathy should be carefully distinguished from progression to lymphoid metastasis, and biopsy should be performed if needed.
Keyphrases
- fine needle aspiration
- ultrasound guided
- drug induced
- lymph node
- high glucose
- diabetic rats
- monoclonal antibody
- multiple sclerosis
- case report
- squamous cell carcinoma
- small cell lung cancer
- chronic kidney disease
- magnetic resonance imaging
- radiation therapy
- endothelial cells
- oxidative stress
- poor prognosis
- early stage
- mesenchymal stem cells
- small molecule
- single molecule
- diffuse large b cell lymphoma
- stress induced
- amino acid
- rectal cancer
- red blood cell
- protein protein