Drug-Induced Lung Disease: A Pragmatic Classification Incorporating HRCT Appearances

Jeffrey L. Myers; Andrew H. Limper; Stephen J. Swensen

doi:10.1055/s-2003-42379

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2003; 24(4): 445-454
DOI: 10.1055/s-2003-42379

Drug-Induced Lung Disease: A Pragmatic Classification Incorporating HRCT Appearances

Jeffrey L. Myers¹ , Andrew H. Limper² , Stephen J. Swensen³

¹Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota
²Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
³Department of Radiology, Mayo Clinic, Rochester, Minnesota

Abstract

ABSTRACT

Drug-induced lung disease frequently poses a diagnostic challenge. Knowledge of common radiological patterns of lung involvement and corresponding histopathologic diagnoses can facilitate management of individual patients. We outline a framework for understanding radiological and histologic patterns of drug-induced lung disease. Diffuse forms of drug-induced lung disease include processes that mimic acute respiratory distress syndrome (ARDS) and diffuse alveolar hemorrhage. These patterns of drug-induced lung disease are especially common in patients receiving cytotoxic chemotherapeutic agents. Chronic forms of drug-induced lung disease include many of the interstitial pneumonias seen more commonly in patients with idiopathic disease. Bronchiolitis obliterans organizing pneumonia and eosinophilic pneumonia are nonspecific patterns of drug-induced lung disease that are radiologically and histologically indistinguishable from their idiopathic counterparts. In some patients organizing pneumonia and eosinophilic pneumonia mimic the radiological appearance of neoplastic disease.

KEYWORDS

Diffuse alveolar damage - nonspecific interstitial pneumonia - usual interstitial pneumonia - bronchiolitis obliterans organizing pneumonia - eosinophilic pneumonia

Full Text

References

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