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Pembrolizumab-Induced Pneumonitis

Imaging findings

Surveillance CT of a patient on pembrolizumab shows new peripheral ground-glass opacities and band-like consolidations (organizing pneumonia pattern). After resolving with steroid therapy, new areas of organizing pneumonia recurred during the steroid taper.

Key takeaways

Immune checkpoint inhibitors (e.g., pembrolizumab) can cause pneumonitis, most commonly presenting as organizing pneumonia. Up to 15% of patients can experience recurrence of pneumonitis during or after steroid tapering.

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