Radiation-induced bronchial stenosis: a new cause of platypnea-orthodeoxia.
Platypnea-orthodeoxia is encountered in a variety of cardiac, pulmonary, and hepatic disorders. We report its occurrence in a 59-year-old man who had had combined external-beam and high dose-rate iridium brachytherapy for a stage I non-small-cell carcinoma of the right upper lobe 2 years earlier. The post-radiation course was complicated by a severe radiation bronchitis; the onset of platypnea-orthodeoxia signalled the development of severe bronchial stenosis that was transiently relieved, initially by dilatation, and later by stent placement, though the patient ultimately died of a pulmonary hemorrhage. The dosage of brachytherapy given, the combined external-beam therapy, and the long survival after completion of radiation therapy were likely factors in the development of bronchial stenosis. We discuss the tomographic and bronchoscopic features of radiation-induced bronchial stenosis.
Awan
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AN
Department of Internal Medicine, Coastal Area Health Education Center, Department of Radiology, New Hanover Regional Medical Center, Wilmington, NC, USA.
Ashraf
R
R
Meyerson
M B
MB
Dunn
T L
TL
D001784:Blood Gas Analysis; D001918:Brachytherapy / Q000009:adverse effects*; D001982:Bronchial Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001991:Bronchitis / Q000175:diagnosis / Q000209:etiology*; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy; D002404:Catheterization; D002423:Cause of Death; D003251:Constriction, Pathologic; D004417:Dyspnea / Q000097:blood / Q000209:etiology*; D017809:Fatal Outcome; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D011187:Posture; D015607:Stents; D014057:Tomography, X-Ray Computed