Diffuse panbronchiolitis as a rare complication of thymectomy and radiation therapy in a patient with thymoma: a case report

BackgroundDiffuse 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...

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Main Authors: Ye Lu, Qi Qi, Dan Qu, Yu Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1496693/full
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author Ye Lu
Qi Qi
Dan Qu
Yu Chen
author_facet Ye Lu
Qi Qi
Dan Qu
Yu Chen
author_sort Ye Lu
collection DOAJ
description BackgroundDiffuse 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 presentationWe 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.ConclusionsClinicians 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.
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spelling doaj-art-86232d4685b943768c183c59ca19eb812025-01-30T05:10:11ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-01-011510.3389/fonc.2025.14966931496693Diffuse panbronchiolitis as a rare complication of thymectomy and radiation therapy in a patient with thymoma: a case reportYe LuQi QiDan QuYu ChenBackgroundDiffuse 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 presentationWe 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.ConclusionsClinicians 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.https://www.frontiersin.org/articles/10.3389/fonc.2025.1496693/fulldiffuse panbronchiolitisthymomacellular immunodeficiencyradiationcase report
spellingShingle Ye Lu
Qi Qi
Dan Qu
Yu Chen
Diffuse panbronchiolitis as a rare complication of thymectomy and radiation therapy in a patient with thymoma: a case report
Frontiers in Oncology
diffuse panbronchiolitis
thymoma
cellular immunodeficiency
radiation
case report
title Diffuse panbronchiolitis as a rare complication of thymectomy and radiation therapy in a patient with thymoma: a case report
title_full Diffuse panbronchiolitis as a rare complication of thymectomy and radiation therapy in a patient with thymoma: a case report
title_fullStr Diffuse panbronchiolitis as a rare complication of thymectomy and radiation therapy in a patient with thymoma: a case report
title_full_unstemmed Diffuse panbronchiolitis as a rare complication of thymectomy and radiation therapy in a patient with thymoma: a case report
title_short Diffuse panbronchiolitis as a rare complication of thymectomy and radiation therapy in a patient with thymoma: a case report
title_sort diffuse panbronchiolitis as a rare complication of thymectomy and radiation therapy in a patient with thymoma a case report
topic diffuse panbronchiolitis
thymoma
cellular immunodeficiency
radiation
case report
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1496693/full
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AT danqu diffusepanbronchiolitisasararecomplicationofthymectomyandradiationtherapyinapatientwiththymomaacasereport
AT yuchen diffusepanbronchiolitisasararecomplicationofthymectomyandradiationtherapyinapatientwiththymomaacasereport