PACLITAXEL-INDUCED CELL-MEDIATED HYPERSENSITIVITY PNEUMONITIS - DIAGNOSIS USING LEUKOCYTE MIGRATION TEST, BRONCHOALVEOLAR LAVAGE AND TRANSBRONCHIAL LUNG-BIOPSY

A 73-year-old man with mild inactive interstitial pneumonitis and non- small cell bronchogenic carcinoma developed a cell-mediated hypersensi tivity pneumonitis within 15 days following a second exposure to pacli taxel, Histological features of transbronchial lung biopsy were consis tent with interstitial pneumonitis. Bronchoalveolar lavage showed incr eased lymphocytes and eosinophils, and decreased helper/suppressor T l ymphocyte ratio, Leukocyte migration inhibitory test was positive for paclitaxel. These results support the possibility that paclitaxel-indu ced pneumonitis is due to delayed type hypersensitivity; they also sup port the hypothesis of a central role of T lymphocytes in drug-induced pneumonitis.