Lung cancer is one of the most common co-morbid conditions in patients with idiopathic pulmonary fibrosis (IPF) and negatively affects the prognosis of IPF; Current guidelines for the management of IPF do not give a clear statement on how to manage these patients, and traditional chemotherapy for lung cancer had a limited efficiency rate. Here, we present a rare case of primary lung squamous carcinoma in a patient with IPF whose tumor completely regressed following gemcitabine plus cisplatin therapy; the cancer was no longer detectable after 2 years upon follow-up. Sixty-seven year-old male patient with IPF was admitted to hospital due to acute onset hemoptysis. In addition to a definite usual interstitial pneumonia (UIP) pattern, a chest CT scan showed a non-enhancing nodular opacity in the right upper lobe and an enhancing nodule in the right lower lobe. Bronchoscopic biopsy of the nodule in the right lower lobe revealed squamous lung cancer. After 2 cycles of chemotherapy with gemcitabine and cisplatin, the tumor in the right lower lobe was no longer detectable after 2 years of follow-up; however, the nodule in the right upper lobe had increased significantly. Finally, Mycobacterium tuberculosis (MTB) was cultured from the bronchoalveolar (BAL) sample submitted at the last evaluation, and the patient was confirmed to have active pulmonary TB. We report the first documented case of complete pulmonary squamous carcinoma regression in IPF following gemcitabine plus cisplatin. Traditional chemotherapy is considered inadequate to cause the resulting regression of the tumor. The concomitant active pulmonary tuberculosis possibly underlies the mechanism.

中文翻译：

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吉西他滨联合顺铂治疗后IPF肺鳞癌完全消退：病例报告并文献复习

肺癌是特发性肺纤维化（IPF）患者最常见的合并症之一，对IPF的预后产生负面影响。当前IPF管理指南未就如何管理这些患者给出明确声明，传统的肺癌化疗效率有限。在此，我们介绍了IPF患者中罕见的原发性肺鳞癌病例，其吉西他滨联合顺铂治疗后肿瘤完全消退。随访2年后不再检测到癌症。67例男性IPF患者因急性咯血入院。除了明确的普通性间质性肺炎（UIP）模式外，胸部CT扫描显示右上叶无增强结节混浊，右下叶增强结节。右下叶结节的支气管镜活检显示鳞状肺癌。经过2个周期的吉西他滨和顺铂化疗后，随访2年后，不再检测到右下叶肿瘤。然而，右上叶的结节明显增加。最后，从上次评估时提交的支气管肺泡（BAL）样品中培养出结核分枝杆菌（MTB），并确认该患者患有活动性肺结核。我们报告了吉西他滨加顺铂后IPF中首例完全肺鳞癌消退的病例。传统化学疗法被认为不足以导致肿瘤的消退。