Open AccessNon‐bacterial cystitis with increased expression of programmed death‐ligand 1 in the urothelium: An unusual immune‐related adverse event during treatment with pembrolizumab for lung adenocarcinoma
Author(s) -
Ueki Yohei,
Matsuki Masahiro,
Kubo Terufumi,
Morita Rena,
Hirohashi Yoshihiko,
Sato Syunsuke,
Horibe Ryota,
Matsuo Kazuhiko,
Tsukahara Tomohide,
Kanaseki Takayuki,
Takakuwa Yasunari,
Satoh Masaaki,
Itoh Naoki,
Torigoe Toshihiko
Publication year - 2020
Publication title -
iju case reports
Language(s) - English
Resource type - Journals
ISSN - 2577-171X
DOI - 10.1002/iju5.12211
Subject(s) - urothelium , medicine , pembrolizumab , nocturia , immune system , immune checkpoint , adverse effect , durvalumab , adenocarcinoma , immunology , immunotherapy , urinary bladder , urinary system , cancer
Immune checkpoint inhibitors are now a standard therapeutic option for lung adenocarcinoma. However, Immune checkpoint inhibitors often induce various immune‐related adverse events. Case presentation The patient was a 78‐year‐old woman with lung adenocarcinoma who had a partial response to pembrolizumab. During treatment, she complained of pollakiuria and nocturia with painful micturition. Histological analysis revealed infiltration of CD8‐positive and/or TIA‐1 cytotoxic granule‐associated RNA binding protein‐positive lymphocytes and programmed death‐ligand 1 expression in the urothelium. A diagnosis of immune‐related adverse event cystitis was made based on these clinical and pathological findings. The patient’s subjective symptoms and findings on cystoscopy improved dramatically after treatment with prednisolone. Conclusion Immune checkpoint inhibitors‐induced cystitis is extremely rare. This report is the first to include an immunohistochemical analysis of the urothelial epithelium in immune‐related adverse event cystitis and describes an instructive case.