Elsevier

Clinical Radiology

Volume 57, Issue 4, April 2002, Pages 292-299
Clinical Radiology

Regular Article
Drug-induced Lung Disease: High-resolution CT and Histological Findings

https://doi.org/10.1053/crad.2001.0792Get rights and content

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. Cleverly, J. R. et al. (2002) Clinical Radiology57, 292–299.

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    Author for correspondence and guarantor of study: Dr Nestor L. Müller, Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, Vancouver, BC V5Z 1M9 Canada. Fax: 604 875-5498; E-mail: [email protected]

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