Fig. 2.

Ipilimumab-related accelerated lung injury in a patient with preexisting pulmonary fibrosis. Severe cough and dyspnea developed 3 weeks after initiation of ipilimumab monotherapy for metastatic prostate cancer. At baseline (a, b), CT imaging showed mild fibrotic changes, consistent with the patient’s known history of idiopathic pulmonary fibrosis. The chest CT on admission showed significant progression of pulmonary fibrosis (c, d) in the upper and lower lobes, which progressed despite withdrawal of the agent and initiation of high-dose steroids. BAL fluids were culture negative. Lung biopsies demonstrated interstitial inflammation and fibrosis, consistent with NSIP, which was thought to be due to Ipilimumab therapy