Drug-induced lung disease: high-resolution CT and histological findings

Clin Radiol. 2002 Apr;57(4):292-9. doi: 10.1053/crad.2001.0792.

Abstract

Aim: To compare the parenchymal high-resolution computed tomography (HRCT) appearances with histological findings in patients with drug-induced lung disease and to determine the prognostic value of HRCT.

Materials and methods: Drug history, HRCT features, histological findings and outcome at 3 months in 20 patients with drug induced-lung disease were reviewed retrospectively. The HRCT images were assessed for the pattern and distribution of abnormalities and classified as most suggestive of interstitial pneumonitis/fibrosis, diffuse alveolar damage (DAD), organizing pneumonia (OP) reaction, or a hypersensitivity reaction.

Results: On histopathological examination there were eight cases of interstitial pneumonitis/fibrosis, five of DAD, five of OP reactions, one of hypersensitivity reaction and one of pulmonary eosinophilia. The most common abnormalities on HRCT were ground-glass opacities (n = 17), consolidation (n = 14), interlobular septal thickening (n = 15) and centrilobular nodules (n = 8). HRCT interpretation and histological diagnosis were concordant in only nine (45%) of 20 patients. The pattern, distribution, and extent of HRCT abnormalities were of limited prognostic value: all eight patients with histological findings of OP, hypersensitivity reaction, or eosinophilic infiltrate improved on follow-up compared to only five of 13 patients with interstitial pneumonitis/fibrosis or DAD.

Conclusion: In many cases of drug-induced lung injury HRCT is of limited value in determining the histological pattern and prognosis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects
  • Drug-Related Side Effects and Adverse Reactions*
  • Female
  • Humans
  • Lung Diseases / chemically induced*
  • Lung Diseases / diagnostic imaging*
  • Lung Diseases / pathology
  • Lung Diseases, Interstitial / chemically induced
  • Lung Diseases, Interstitial / diagnostic imaging
  • Male
  • Middle Aged
  • Pneumonia / chemically induced
  • Pneumonia / diagnostic imaging
  • Pneumonia / pathology
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*

Substances

  • Antineoplastic Agents