CTICasesOrganizing Pneumonia Triggered by Radiation Therapy
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Imaging findings
Initial radiograph shows consolidation in the right upper lobe, which becomes more pronounced despite antibiotic treatment. CT reveals strikingly peripheral and patchy consolidation with some bubbliness and a peribronchial component, consistent with an organizing pneumonia pattern. Subsequent radiograph after steroid treatment shows dramatic clearing. After steroid tapering, new nodular opacity in the right mid lung and dramatic peripheral apical plastered consolidation in the left upper lung appear, which again clear with reinstated steroids.
Key takeaways
Radiation therapy, particularly for breast cancer, can trigger organizing pneumonia even in areas well outside the radiation port. This condition responds dramatically to steroids. Radiographic appearance is characteristic of organizing pneumonia with migratory or recurrent patchy consolidation.
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