Radiation-induced pneumonitis in the 'nonirradiated' lung

K. R. Arbetter, U. B S Prakash, H. D. Tazelaar, W. W. Douglas

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

Objective: To describe six cases of radiation-induced organizing pneumonitis occurring outside the direct radiation field and to review clinical, radiologic, and histologic 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 histologic 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 immunologically mediated lymphocytic alveolitis may be responsible for the recurrent migratory organizing pneumonitis.

Original languageEnglish (US)
Pages (from-to)27-36
Number of pages10
JournalMayo Clinic Proceedings
Volume74
Issue number1
StatePublished - 1999

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Radiation Pneumonitis
Lung
Adrenal Cortex Hormones
Radiation
Pneumonia
Radiotherapy
Cryptogenic Organizing Pneumonia
Lymphocytosis
Bronchoalveolar Lavage
Therapeutics
Thorax
Tomography
Breast Neoplasms
Biopsy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Arbetter, K. R., Prakash, U. B. S., Tazelaar, H. D., & Douglas, W. W. (1999). Radiation-induced pneumonitis in the 'nonirradiated' lung. Mayo Clinic Proceedings, 74(1), 27-36.

Radiation-induced pneumonitis in the 'nonirradiated' lung. / Arbetter, K. R.; Prakash, U. B S; Tazelaar, H. D.; Douglas, W. W.

In: Mayo Clinic Proceedings, Vol. 74, No. 1, 1999, p. 27-36.

Research output: Contribution to journalArticle

Arbetter, KR, Prakash, UBS, Tazelaar, HD & Douglas, WW 1999, 'Radiation-induced pneumonitis in the 'nonirradiated' lung', Mayo Clinic Proceedings, vol. 74, no. 1, pp. 27-36.
Arbetter KR, Prakash UBS, Tazelaar HD, Douglas WW. Radiation-induced pneumonitis in the 'nonirradiated' lung. Mayo Clinic Proceedings. 1999;74(1):27-36.
Arbetter, K. R. ; Prakash, U. B S ; Tazelaar, H. D. ; Douglas, W. W. / Radiation-induced pneumonitis in the 'nonirradiated' lung. In: Mayo Clinic Proceedings. 1999 ; Vol. 74, No. 1. pp. 27-36.
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