HRCT Patterns of Drug-Induced Interstitial Lung Diseases: A Review

Abstract

Interstitial Lung Diseases (ILDs) represent a heterogeneous group of pathologies, which may be related to different causes. A low percentage of these lung diseases may be secondary to the administration of drugs or substances. Through the PubMed database, an extensive search was performed in the fields of drug toxicity and interstitial lung disease. We have evaluated the different classes of drugs associated with pulmonary toxicity. Several different high resolution computed tomography (HRCT) patterns related to pulmonary drug toxicity have been reported in literature, and the most frequent ILDs patterns reported include Nonspecific Interstitial Pneumonia (NSIP), Usual Interstitial Pneumonia (UIP), Hypersensitivity Pneumonitis (HP), Organizing Pneumonia (OP), Acute Respiratory Distress Syndrome (ARDS), and Diffuse Alveolar Damage (DAD). Finally, from the electronic database of our Institute we have selected and commented on some cases of drug-induced lung diseases related to the administration of common drugs. As the imaging patterns are rarely specific, an accurate evaluation of the clinical history is required and a multidisciplinary approach—involving pneumologists, cardiologists, radiologists, pathologists, and rheumatologists—is recommended.

Ground-glass opacity (GGO): a review of the differential diagnosis in the era of COVID-19

“…Some drugs can manifest their toxicity with interstitial pneumonia and differential diagnosis with viral infection could be tricky. OP could be cryptogenic or caused also by infective or other non-infective diseases (post-radiotherapy, vasculitis, collagen, and interstitial lung diseases) [77]. On HRCT, OP shows multifocal GGO and consolidations, usually with a broncho-vascular distribution: reversed halo sign (called also "atoll sign") is typical, even if it is present in only 20% of cases (Fig.…”

The CT pulmonary vascular parameters and disease severity in COPD patients on acute exacerbation: a correlation analysis

“…Furthermore, whether it is overall or local, unilateral or bilateral, chest CT can observe and accurately measure the lung volume, which is irreplaceable for lung function tests that can only measure the sum of bilateral lung volumes, especially it is a preoperative evaluation of patients who are about to undergo surgery [ 41 , 42 ]. Furthermore, chest CT is simple and safe to perform for the deficiency of COPD patients with severe illness and patients with acute attacks who cannot cooperate with the lung function tests [ 43 ]. With the advent of the third-generation dual-source CT, the scan time of the chest HRCT is less than 3 s [ 44 ].…”

Drug-Related Pneumonitis in Cancer Treatment during the COVID-19 Era

“…As defined by the American Thoracic Society and the European Respiratory Society (ATS/ERS) in correlation with histological findings, the most common patterns are presented below [ 137 ]. It is worth noting that it may occasionally not be possible to identify a case with a specific pattern, and even overlapping among them is possible [ 138 ].…”