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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Bronchiolitis obliterans organising pneumonia: a consequence of breast radiotherapy
  1. Ahmed Fahim1,
  2. Anne P Campbell2,
  3. Simon Paul Hart3
  1. 1Department of Cardiovascular and Respiratory Studies, Castle Hill Hospital, Cottingham, UK
  2. 2Department of Histopathology, Hull and East Yorkshire NHS Trust, Cottingham, UK
  3. 3Department of Cardiovascular and Respiratory Studies, Hull York Medical School/University of Hull, Hull, UK
  1. Correspondence to Dr Ahmed Fahim, ahmedfahim{at}doctors.org.uk

Summary

The authors describe a case of 51-year-old woman who presented with breathlessness following radiotherapy for breast carcinoma. A chest radiograph and thoracic CT scan revealed extensive airspace consolidation affecting right upper and lower lobes. A trans-bronchial biopsy revealed evidence of foamy macrophages and fibroblastic plugs within alveoli, consistent with organising pneumonia. Indirect immunofluorescence microscopy revealed evidence of antiepithelial antibodies. Gradual but complete resolution occurred without any specific treatment. This case highlights the importance of considering radiation induced bronchiolitis obliterans organising pneumonia in the context of parenchymal shadowing following radiotherapy. Although corticosteroids are widely recommended for treatment, this case illustrates that organising pneumonia may resolve spontaneously.

https://doi.org/10.1136/bcr.10.2011.4987

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    Footnotes

    • Competing interests None.

    • Patient consent Obtained.