Rituximab-induced pneumonitis mimicking miliary tuberculosis.

To the Editor: Rituximab, a chimeric anti-CD20 monoclonal antibody, is commonly being used in combination with chemotherapy regimens in the standard treatment of B-cell non-Hodgkin lymphoma (NHL) [1]. Rituximab is considered to be a relatively safe drug but recently, severe and fatal interstitial lung disease (ILD) was noted with an occurrence rate of 0.01–0.03% [2]. Computed tomography (CT) patterns of rituximab-induced ILD include focal (54%) or diffused (9%) alveolar patterns and macronodules (3%), or ground-glass patterns (34%) [2]. In this regard, we report a patient with NHL in whom ILD developed after six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) therapy with diffused micronodules mimicking miliary tuberculosis (TB). …