TY - JOUR
T1 - Radiation-induced pneumonitis in the "nonirradiated" lung
AU - Arbeiter, Kenneth R.
AU - Prakash, Udaya B.S.
AU - Tazelaar, Henry D.
AU - Douglas, William W.
N1 - Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 1999
Y1 - 1999
N2 - Objective: To describe six cases of radiation-induced organizing pneumonitis occurring outside the direct radiation field and to review clinical, radiologie, and histologie aspects of this entity. Material and Methods: We present detailed case reports of six women, with a mean age of 62.8 years (range, 50 to 75), who had received radiation therapy (mean dose, 6,560 cGy) for breast cancer. Results: From 6 to 17 months (mean, 8.8) after the completion of radiotherapy, recurrent and migrating lung infiltrates were detected outside the radiation field in the six study patients. Three patients had pronounced respiratory symptoms, whereas the rest were minimally symptomatic or asymptomatic. Thoracic computed tomography showed dense alveolar infiltrates. Bronchoalveolar lavage in two patients revealed lymphocytosis (25% and 19%), and lung biopsy in five patients demonstrated a histologie pattern consistent with bronchiolitis obliterans organizing pneumonia. Even though the symptomatic patients showed prompt resolution of their symptoms and roentgenographic abnormalities after systemic corticosteroid therapy, the lung infiltrates recurred after corticosteroid therapy was discontinued. Conclusion: These six cases, including their prompt response to corticosteroid therapy, provide additional evidence that irradiation damages lung tissue outside of the direct treatment field and suggest that an immimologically mediated lymphocytic alveolitis may be responsible for the recurrent migratory organizing pneumonitis.
AB - Objective: To describe six cases of radiation-induced organizing pneumonitis occurring outside the direct radiation field and to review clinical, radiologie, and histologie aspects of this entity. Material and Methods: We present detailed case reports of six women, with a mean age of 62.8 years (range, 50 to 75), who had received radiation therapy (mean dose, 6,560 cGy) for breast cancer. Results: From 6 to 17 months (mean, 8.8) after the completion of radiotherapy, recurrent and migrating lung infiltrates were detected outside the radiation field in the six study patients. Three patients had pronounced respiratory symptoms, whereas the rest were minimally symptomatic or asymptomatic. Thoracic computed tomography showed dense alveolar infiltrates. Bronchoalveolar lavage in two patients revealed lymphocytosis (25% and 19%), and lung biopsy in five patients demonstrated a histologie pattern consistent with bronchiolitis obliterans organizing pneumonia. Even though the symptomatic patients showed prompt resolution of their symptoms and roentgenographic abnormalities after systemic corticosteroid therapy, the lung infiltrates recurred after corticosteroid therapy was discontinued. Conclusion: These six cases, including their prompt response to corticosteroid therapy, provide additional evidence that irradiation damages lung tissue outside of the direct treatment field and suggest that an immimologically mediated lymphocytic alveolitis may be responsible for the recurrent migratory organizing pneumonitis.
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U2 - 10.4065/74.1.27
DO - 10.4065/74.1.27
M3 - Article
C2 - 9987529
AN - SCOPUS:0032895605
SN - 0025-6196
VL - 74
SP - 27
EP - 36
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 1
ER -