A 44-year-old man was admitted to our hospital with fever, eruptions, and dyspnea. Chest computed tomography (CT) showed bilateral diffuse ground-glass opacities and multiple ill-defined nodules. Primary varicella pneumonia was diagnosed on the basis of typical eruptions, high titer of antibody against varicella-zoster virus. The demonstration of varicella-zoster virus DNA in vesicle fluid specimen by the polymerase chain reaction technique was useful in the formulation of a definitive diagnosis. The patient was treated with acyclovir, methylprednisolone, immunoglobulin and antibiotics, and fever and respiratory failure improved.

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An 89-year-old man who had been diagnosed with COVID-19 was admitted to our hospital. Dexamethasone 6.6 mg/day was started on the 1st day, and the administration schedule was 10 days in total. Since the respiratory condition deteriorated despite the start of the treatment, we decided to start the infusion of remdesivir on the 5th day. A plain chest radiography showed that multiple infiltrative shadows gradually worsened in both lungs. On the 27th day, chest CT showed consolidation and ground glass shadow in both lungs, and the patient was diagnosed with secondary organizing pneumonia. Prednisolone treatment improved secondary organizing pneumonia.

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A 51-year-old man presented at our hospital with chief complaints of headache and amnesia. Magnetic resonance imaging of the head revealed hydrocephalus caused by a pineal tumor, for which endoscopic third ventriculostomy and tumor biopsy were performed. The patient was subsequently diagnosed with a neuroendocrine tumor. The shadow of a mass was also observed in the right pulmonary hilar region, which was diagnosed as small cell lung cancer based on bronchoscopic biopsy. Since the tumor was histologically similar to the pineal tumor, chemotherapy with immune checkpoint inhibitors was performed for advanced small cell lung cancer with pineal metastasis. Pineal metastasis of small cell lung cancer is rare and no previous reports have described its treatment using chemotherapy in combination with an immune checkpoint inhibitor. We report here the course of treatment for this patient along with a review of the literature.

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