Archive of Old Cases
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Case No : 205 Date 2001-10-01
- Courtesy of Myung Jin Chung, M.D. / Nowon Eulji Hospital, Seoul, Korea
- Age/Sex 47 / F
- Chief ComplaintChronic Cough, mild fever for 3 months. Increased blood ESR and CRP level. History of lumpectomy due to breast cancer 6 months previously.
Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Radiation Pneumonitis
- Radiologic Findings
- Chest radiograph shows lobar atelectasis of RUL with round opacity around right pulmonay hilum. Multiple dilated air-bronchograms are seen within the consolidation. HRCT shows cicatrization atelectasis of RUL with traction bronchiectasis. There is no proximal obstructing lesion. There are multiple patchy nodular consolidations in RLL superior segment and linear consolidation in RML medial segment. Followup chest radiograph after steroid therapy shows marked improvement of consolidation.
- Brief Review
- The earliest radiographic changes appear 6 to 8 weeks after the begining of radiation therapy,and the peak reaction occurs at 3 to 4 months. In the phase of acute radiation pneumonitis, patchy and increasingly confluent areas of increaed attenuation appear in the irradiated field.In the phase of regeneration and fibrosis, fibrous atranding becomes apparent, and contraction can be recognized by distortion of adjacent structures. This radiation fibrosis is prototype of adhesive atelectasis. Radiation pneumonitis can be treated successfully with corticosteroids. If symptomatic radiation pneumonitis is diagnosed early it can be treated well and than has a good prognosis.
- References
- 1. Davis SD, Yankelevitz DF, Henschke CI Radiation effects on the lung: clinical features, pathology and imaging findings AJR 1992; 159: 1157-1164
2. Mah K, Poon PY, Dyk JV, et al. Assessment of acute radiation-induced pulmonary changes using computed tomography J Comput Assist Tomogr 1986; 10: 736-743 - Keywords
- Lung, Non-infectious inflammation, Radiation complication,
No. of Applicants : 18
- ▶ Correct Answer : 15/18, 83.3%
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- - 嫄닿뎅
- - 怨
- - 怨
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- - 源
- - 源
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- - CHU Nancy-Brabois, France Denis Regent
- - IMSL, metz, France Eric Gaconnet
- - Matsuyama Red Cross Hospital,Matsuyama,Japan Shunya Sunami
- - Ospedale di Fabriano, Italy Giancarlo Passarini
- - Seoul National University Hospital Tae Jung Kim
- - Stedelijk OLV Ziekenhuis Mechelen, Belgium Ivan Pilate
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