CTICasesRadiation-Induced Migratory Organizing Pneumonia After Breast Cancer Treatment
Imaging findings
In a woman previously treated with chest wall radiation for breast cancer roughly six months earlier, serial chest radiographs show consolidation initially in the irradiated left lung that partially resolves, only for new consolidation to develop in the contralateral, non-irradiated lung six weeks later. CT shows sharply marginated, peribronchovascular ground-glass and consolidative opacities with spared secondary lobules, without nodules or effusion.
Key takeaways
Migratory consolidation with clean, sharply marginated peribronchovascular opacities and spared lobules, arising within the first year after chest wall radiation and spreading beyond the original radiation field, represents radiation-induced organizing pneumonia; the migratory, contralateral spread is a well-described but poorly understood phenomenon, possibly related to a systemic immune response triggered by localized radiation (an "abscopal"-type effect) that may be potentiated by concurrent chemotherapy.
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