CTICasesRecall Radiation Pneumonitis in a Previously Irradiated Breast Field
Imaging findings
In a patient with a history of bilateral breast conservation therapy and radiation who later developed a thoracic spine metastasis treated with spinal radiation, serial CTs show progressive ground-glass opacity and then frank consolidation localized to the same bilateral subareolar regions that had shown only chronic post-radiation scarring on the baseline study, developing years after the original breast irradiation and without any new radiation delivered to that region.
Key takeaways
New consolidation confined to a previously irradiated field, occurring long after the original radiation and without new radiation to that site, can represent a recall-type phenomenon triggered by a separate, remote inflammatory or therapeutic stimulus -- recognizing the geographic overlap with an old radiation field is key to avoiding a mistaken diagnosis of infection or recurrent tumor.
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