Illness After Irradiation

[Reasonable Rascal]

BACKGROUND

A 65-year-old woman received radiation therapy in her left axilla after she underwent resection for a stage II breast cancer. Four weeks later, she had a fever, dyspnea, a productive cough, and night sweats.

Hint

Analysis of the samples collected during bronchioalveolar lavage did not reveal any organisms. Findings from transbronchial biopsy indicated alveolar septal thickening and desquamation of alveolar lining cells due to round cell infiltration.

[themadmedic]

Well done? or Extra Crispy?

[Reasonable Rascal]

Answer:

Radiation pneumonitis: Pulmonary irradiation may cause acute radiation pneumonitis within 1-6 months after therapy, or it may cause pulmonary fibrosis at later date. The radiographic feature that indicates radiation pneumonitis is a characteristic pulmonary opacity. A line of demarcation separates the area of pneumonitis from normal tissues, but pneumonitis has no regard for anatomic boundaries. Patchy consolidation, the typical radiographic change, usually appears at approximately 8 weeks after disease onset. With time, these opacities become linear or reticular, and fibrous contraction occurs, leading to radiation fibrosis.

[themadmedic]

:kool: