Bronchiolitis obliterans organising pneumonia: a consequence of breast radiotherapy

BMJ Case Rep. 2012 Jan 18:2012:bcr1020114987. doi: 10.1136/bcr.10.2011.4987.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Breast Neoplasms / radiotherapy*
  • Carcinoma / radiotherapy*
  • Cryptogenic Organizing Pneumonia / diagnosis
  • Cryptogenic Organizing Pneumonia / diagnostic imaging
  • Cryptogenic Organizing Pneumonia / etiology*
  • Cryptogenic Organizing Pneumonia / pathology
  • Diagnosis, Differential
  • Female
  • Humans
  • Lung / pathology
  • Microscopy, Fluorescence
  • Middle Aged
  • Remission, Spontaneous
  • Tomography, X-Ray Computed