Prizadetost pljuč in srca po obsevanju ter kemoterapiji Hodgkinove bolezni Lung and heart impairment after irradiation and chemotherapy for Hodgkin's disease

a case study

Abstract

Akutne in kronične okvare pljuč po zdravljenju raka v otroštvu so po sodobnem zdravljenju redke in običajno brez kliničnih znakov ter simptomov. Pri bolnici, ki je bila v otroštvu zdravljena zaradi Hodgkinovega limfoma z obsevanjem vratu, supraklavikularnih bezgavk in mediastinuma ter s kemoterapijo, so kvarne posledice verjetna kombinacija neugodnih učinkov tega zdravljenja na srce in pljuča. Pri naši bolnici je glede na potek in napredovanje pljučne prizadetosti v ospredju vaskularna prizadetost - pljučna vaskulopatija, ki je bila s histološkim pregledom bioptata pljučnega tkiva tudi potrjena. Pri opisu želimo opozoriti na kroničen ter progredienten potek bolezni, ki terja zahtevno obravnavo specialistov in 22 let po zdravljenju povzroča težko invalidnost.

Abstract (Eng)

Acute and chronic defects following childhood cancer treatment are rare with modern treatment techniques and usually without any clinical signs and symptoms. In a patient who was treated for childhood Hodgkin's lymphoma with irradiation to the neck, supraclavicular lymph nodes and mediastinum and chemotherapy, the consequences include a probable combination of adverse effects of this treatment on the lungs and heart. Considering the course and progression of lung impairment, vascular impairment - pulmonary vasculopathy was found to be at the forefront in our patient, which was confirmed by histological examination of the lung-tissue bioptat.
By describing this case, we wish to point to the chronic and progredient course of the disease which requires complex management by specialists and causes severe disability 22 years after treatment.