Erasmus Jeremy J, McAdams H Page, Rossi Santiago E
Department of Radiology, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
Semin Roentgenol. 2002 Jan;37(1):72-81. doi: 10.1053/sroe.2002.0000.
Lung injury is an increasing cause of morbidity and mortality in patients treated with cytotoxic and noncytotoxic drugs. Prompt diagnosis is important because early drug-induced lung injury will often regress with the cessation of therapy. Diagnosis requires a high index of suspicion because infection, radiation pneumonitis, and recurrence of the underlying disease can manifest clinically and radiologically in a similar manner. Because the lungs have only a limited number of histopathologic responses to injury, including pulmonary edema/diffuse alveolar damage, NSIP, BOOP, EP, and pulmonary hemorrhage, knowledge of these manifestations and the corresponding radiologic manifestations can often be useful in suggesting a diagnosis of drug-induced lung injury. An understanding of the drugs most commonly associated with lung injury can also facilitate diagnosis.
肺损伤是接受细胞毒性和非细胞毒性药物治疗的患者发病和死亡的一个日益常见的原因。及时诊断很重要,因为早期药物性肺损伤通常会随着治疗的停止而消退。诊断需要高度的怀疑指数,因为感染、放射性肺炎和基础疾病的复发在临床和影像学上可能表现相似。由于肺对损伤的组织病理学反应数量有限,包括肺水肿/弥漫性肺泡损伤、非特异性间质性肺炎、闭塞性细支气管炎伴机化性肺炎、嗜酸细胞性肺炎和肺出血,了解这些表现以及相应的影像学表现通常有助于提示药物性肺损伤的诊断。了解最常与肺损伤相关的药物也有助于诊断。