A Case of Drug-Induced Interstitial Lung Disease Caused by Epirubicin and Cyclophosphamide Therapy Before Breast Cancer Surgery

We report a case of drug-induced interstitial lung disease (ILD) caused by epirubicin and cyclophosphamide (EC) therapy in a patient with breast cancer. The patient suffered from a dry cough, fever, and exertional dyspnea after two courses of EC therapy. Antibiotic treatment did not improve her symptoms. Chest CT images revealed diffuse, ground-glass opacities and mild interlobular septal thickening in both lungs, a pattern suggesting a hypersensitivity pneumonitis. Bronchoalveolar lavage fluid analysis revealed lymphocytosis with no evidence of infection nor malignancy. Corticosteroid therapy was initiated, which led to a rapid resolution of ILD. To date, there has been only one case report regarding drug-induced ILD caused by EC therapy. This case report could increase awareness of chemotherapy-induced pneumonitis.