[Ct findings of drug-induced pneumonitis--characteristic CT findings by histological group and subgroup]

Nihon Kokyuki Gakkai Zasshi. 2004 Feb;42(2):145-52.
[Article in Japanese]

Abstract

We examined the chest CT results of 27 cases of drug-induced pneumonitis. We classified the subjects into 3 groups in accordance with the clinicopathological findings: eosinophilic pneumonia (EP) group (5 cases), diffuse alveolar damage (DAD) group (3 cases), and interstitial pneumonia (IP) group (19 cases). We evaluated the CT findings in each group, and made a further subclassification. In the EP group, the CT findings were subdivided into two, namely, type A, with diffuse distribution consistent with CT findings of acute eosinophilic pneumonia; and type B, with subpleural distribution consistent with chronic eosinophilic pneumonia. In the DAD group, the CT findings were diffuse distribution of mixed ground-glass attenuation and air-space consolidation, with or without traction bronchiectasis, and without shrinking of the lung. In the IP group, the CT findings were subdivided into 3, namely type A, with ground-glass attenuation dominant, without traction bronchiectasis or shrinking of the lung, consistent with the CT findings of IP without fibrosis; type B, with air-space consolidation dominant, with traction bronchiectasis and shrinking of the lung, consistent with the CT findings of IP with fibrosis; and type C with multiple nodules dominant. Radiological differentiation of the DAD group from IP-type B may be possible by the presence or absence of a shrinking lung pattern. We concluded that the subgroups of CT findings in drug-induced pneumonitis may be useful for diagnosis of this disease, and for prognosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents / adverse effects
  • Antirheumatic Agents / adverse effects
  • Drug-Related Side Effects and Adverse Reactions*
  • Drugs, Chinese Herbal / adverse effects
  • Female
  • Humans
  • Lung / diagnostic imaging*
  • Lung / pathology*
  • Male
  • Methotrexate / adverse effects
  • Middle Aged
  • Organogold Compounds
  • Pneumonia / chemically induced*
  • Pneumonia / classification
  • Pneumonia / pathology*
  • Tomography, X-Ray Computed*

Substances

  • Anti-Infective Agents
  • Antirheumatic Agents
  • Drugs, Chinese Herbal
  • Organogold Compounds
  • Methotrexate