A 63-year-old
female diagnosed with relapsed
multiple myeloma visited our
hospital complaining of a
persistent cough. Since July 2006, she had been taking 100 mg
thalidomide daily and gradually developed
shortness of breath and a persistent dry
cough. A
chest X-ray and computed
tomography showed ground
glass opacities in both
lungs. An open
lung biopsy of the right middle lobe under
general anesthesia revealed chronic peribronchial
inflammation, mild interstitial
fibrosis, and intra-
alveolar macrophage infiltration, with some
hemosiderin features, compatible with non-specific
interstitial pneumonia (NSIP). After discontinuing the
thalidomide, the
patient's symptoms did not deteriorate, although the radiographs did not improve. The
patient is alive and well with regular
outpatient follow-up without progression of the NSIP.