AJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ellis, S. J.
Right arrow Articles by Müller, N. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ellis, S. J.
Right arrow Articles by Müller, N. L.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Hotlight (NEW!)
Right arrow
What's Hotlight?

Drug-Induced Lung Disease

High-Resolution CT Findings

Samantha J. Ellis1, Joanne R. Cleverley and Nestor L. Müller

1 All authors: Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W. 12th Ave., Vancouver, B.C., V5Z 1M9, Canada.



View larger version (122K):

[in a new window]
  		Fig. 1. —61-year-old man with interstitial fibrosis; patient was receiving chlorambucil for chronic lymphocytic leukemia. High-resolution CT scan shows irregular linear opacities and ground-glass opacities in predominantly subpleural distribution. Differential diagnosis includes drug toxicity, opportunistic infection, and leukemic opacities. Diagnosis was confirmed at lung biopsy.

 


View larger version (93K):

[in a new window]
  		Fig. 2. —47-year-old woman with hypersensitivity reaction; patient was receiving bleomycin for Hodgkin's disease. High-resolution CT scan of chest shows extensive bilateral ground-glass opacities and poorly defined centrilobular nodules (arrows). Primary diagnostic considerations are drug toxicity, opportunistic infection, and pulmonary hemorrhage. Diagnosis was confirmed at open lung biopsy.

 


View larger version (113K):

[in a new window]
  		Fig. 3. —57-year-old man with drug-induced adult respiratory distress syndrome; patient was receiving bleomycin for non—Hodgkin's lymphoma. High-resolution CT scan reveals extensive bilateral ground-glass opacities primarily involving dependent lung regions. Differential diagnosis includes opportunistic infection, drug toxicity, and pulmonary hemorrhage. Diagnosis was confirmed at open lung biopsy.

 


View larger version (120K):

[in a new window]
  		Fig. 4. —58-year-old man with bronchiolitis obliterans organizing pneumonia; patient was receiving busulfan and cyclophosphamide chemotherapy for multiple myeloma. High-resolution CT scan shows peripheral areas of consolidation. Note striking left-sided predominance. Differential diagnosis includes bacterial or fungal pneumonia and adverse drug reaction. Diagnosis was confirmed at lung biopsy.

 


View larger version (112K):

[in a new window]
  		Fig. 5. —60-year-old man with bronchiolitis obliterans organizing pneumonia; patient was receiving amiodarone for ischemic heart disease. High-resolution CT scan of right lung shows irregular linear opacities, ground-glass opacities, and focal areas of consolidation. Differential diagnosis includes pneumonia, adverse drug reaction, and pulmonary edema. Diagnosis was confirmed at lung biopsy.

 


View larger version (100K):

[in a new window]
  		Fig. 6. —77-year-old man with bronchiolitis obliterans organizing pneumonia; patient was receiving amiodarone for treatment of cardiac arrhythmia. High-resolution CT scan shows extensive bilateral ground-glass opacities and dependent areas of consolidation. Diagnostic considerations include pneumonia, pulmonary edema, and adverse drug reaction. Diagnosis was confirmed at lung biopsy.

 


View larger version (87K):

[in a new window]
  		Fig. 7A. —60-year-old man with high attenuation caused by amiodarone toxicity. Mediastinal windows reveal high-attenuation of parenchymal lesions (arrows).

 


View larger version (135K):

[in a new window]
  		Fig. 7B. —60-year-old man with high attenuation caused by amiodarone toxicity. Liver has uniform high attenuation, marker of amiodarone exposure but not necessarily toxicity.

 


View larger version (114K):

[in a new window]
  		Fig. 8. —74-year-old woman with interstitial fibrosis; patient was receiving nitrofurantoin for recurrent urinary tract infections. High-resolution CT scan shows predominantly basal subpleural reticular and ground-glass opacities. Differential diagnosis includes adverse drug reaction, unrelated interstitial lung disease, and pneumonia. Diagnosis was confirmed at open lung biopsy.

 


View larger version (98K):

[in a new window]
  		Fig. 9. —81-year-old woman with bronchiolitis obliterans organizing pneumonia; patient was receiving nitrofurantoin for recurrent urinary tract infections. High-resolution CT scan shows bilateral areas of consolidation in predominantly peribronchial and subpleural distribution. Primary diagnostic considerations are bronchopneumonia, idiopathic bronchiolitis obliterans organizing pneumonia, and adverse drug reaction. Diagnosis was confirmed at transbronchial biopsy.

 


View larger version (103K):

[in a new window]
  		Fig. 10. —52-year-old man with hypersensitivity reaction; patient was receiving methotrexate for rheumatoid arthritis. High-resolution CT scan shows poorly defined centrilobular nodules (arrows) and extensive areas of ground-glass attenuation. Differential diagnosis includes interstitial pneumonitis related to rheumatoid arthritis, opportunistic infection, and adverse drug reaction. Diagnosis was confirmed at open lung biopsy.

 


View larger version (117K):

[in a new window]
  		Fig. 11. —70-year-old man with bronchiolitis obliterans organizing pneumonia; patient was receiving methotrexate for temporal arteritis. High-resolution CT scan shows bilateral ground-glass opacities, linear opacities, and patchy areas of consolidation. Primary differential diagnosis includes opportunistic infection, drug-induced lung disease, or unrelated interstitial pneumonitis. Diagnosis was made at open lung biopsy.

 


View larger version (169K):

[in a new window]
  		Fig. 12A. —27-year-old female IV drug abuser with talcosis. High-resolution CT scan shows magnified view of left lung. Conglomerate mass is seen on background of fine micronodular interstitial pattern.

 


View larger version (94K):

[in a new window]
  		Fig. 12B. —27-year-old female IV drug abuser with talcosis. Same image as A obtained with mediastinal windows confirms high attenuation of consolidative mass caused by talc accumulation. Findings are virtually diagnostic of talcosis.

 


View larger version (136K):

[in a new window]
  		Fig. 13. —63-year-old man with panacinar emphysema and long history of IV methylphenidate abuse. CT scan (3-mm collimation) shows severe lower lobe panacinar emphysema. Identical appearance may be seen in patients with {alpha}1-antitrypsin deficiency.

 

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2000 by the American Roentgen Ray Society.