Acute febrile illness associated with bilateral pulmonary infiltrates after irradiation in a patient with Hodgkin's disease.
An 18-year-old woman with stage IIIB Hodgkin's disease presented with minimal shortness of breath and progressed to fatal pulmonary insufficiency in five days. Biopsy and necropsy lung tissue specimens established the diagnosis of acute radiation pneumonitis. The diagnosis of radiation pneumonitis should be considered in the presence of a nonproductive cough, dyspnea, mixed interstitial and alveolar infiltrates on chest roentgenogram, negative cultures, and the characteristic findings on lung biopsy of macrophage accumulation and alveolar fibrin deposition in the face of minimal cellular infiltrate. A trial of steroid treatment may be warranted.
D000208:Acute Disease; D000293:Adolescent; D001706:Biopsy; D005260:Female; D005334:Fever / Q000209:etiology*; D006689:Hodgkin Disease / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D011014:Pneumonia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D011859:Radiography; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage