Awan A N, Ashraf R, Meyerson M B, Dunn T L
Department of Internal Medicine, Coastal Area Health Education Center, Department of Radiology, New Hanover Regional Medical Center, Wilmington, NC, USA.
South Med J. 1999 Jul;92(7):720-4. doi: 10.1097/00007611-199907000-00014.
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.
平卧呼吸困难-直立性低氧血症可见于多种心脏、肺部和肝脏疾病。我们报告了一名59岁男性出现这种情况，该患者两年前因右上叶I期非小细胞癌接受了外照射和高剂量率铱近距离放射治疗。放疗后的病程因严重的放射性支气管炎而复杂化；平卧呼吸困难-直立性低氧血症的出现标志着严重支气管狭窄的发展，最初通过扩张暂时缓解，后来通过放置支架缓解，尽管患者最终死于肺出血。近距离放射治疗的剂量、联合外照射治疗以及放疗完成后的长期存活可能是支气管狭窄发生的因素。我们讨论了放射性支气管狭窄的断层扫描和支气管镜特征。
