A 61-year-old man with a history of Hodgkin lymphoma underwent mediastinal radiation therapy 7 months ago. He now presents with progressive dyspnea and dry cough. Vital signs show BP 138/82 mmHg, HR 102 bpm, RR 22/min, SpO2 92% on room air, and temperature 37.2°C. CT chest demonstrates fibrotic changes confined to the irradiated field. Pulmonary function tests show reduced DLCO. He denies fever or productive sputum. Which diagnosis best explains these findings?
- A)Radiation induced pulmonary fibrosisGABARITO
- B)Chylothorax
- C)Usual interstitial pneumonia unrelated to therapy
- D)Diffuse alveolar hemorrhage
- E)Acute eosinophilic pneumonia
Explicação
Radiation induced lung injury typically begins with pneumonitis weeks to months after treatment and can progress to fibrosis over 6 to 12 months. The localization to the radiation field is a key clue. Cytokine driven inflammation followed by fibroblast activat... Ver explicação completa e trilha adaptativa →