CTICasesRadiation-Induced Organizing Pneumonia after Breast Cancer Radiotherapy
Imaging findings
A middle-aged woman with shortness of breath had an unremarkable chest radiograph, but CT performed to evaluate for pulmonary embolism showed peripheral, perilobular ground-glass opacity arcading along the bronchovascular bundles, primarily in the left upper lobe, patchy and interspersed with normal lung, a pattern typical for organizing pneumonia. The patient had been treated with tangential radiation for early-stage breast cancer within the preceding four months.
Key takeaways
A perilobular, arcading pattern of organizing pneumonia arising outside the original radiation field, and sometimes extending to the contralateral lung, should prompt review of recent radiotherapy history, since radiation-induced organizing pneumonia is a well-described reaction that can occur up to a year after treatment and is managed successfully with steroids once infection and connective tissue disease have been reasonably excluded.
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