Bilateral lymphocytic alveolitis: a common reaction after unilateral thoracic irradiation

The main aim of the present study was to assess the early diagnostic value of bronchoalveolar lavage (BAL) in radiation-induced lung injury in patients with breast carcinoma. Twenty-six females receiving postoperative radiotherapy for breast cancer were evaluated before and 0, 15, 30, 60, and 180 days after radiotherapy. History, physical examination, chest radiographs, and pulmonary function tests were obtained. BAL, including lymphocyte subsets analysis, was limited to the second evaluation after radiotherapy. A group of 21 healthy females were used as control. Findings after radiotherapy in asymptomatic patients were compared with findings in a group of patients with radiation pneumonitis. Irradiated patients showed a significantly (p<0.01) greater percentage (29.5+/-15.7%) of BAL lymphocytes than controls (6.2+/-3.3%). No statistical differences existed in BAL findings between the irradiated and unirradiated sides of the chest. Percentages of BAL lymphocytes did not differ significantly between patients who developed subsequent pneumonitis (24.5+/-13.5%) and those who did not develop pneumonitis (32.8+/-16.5%). Patients with pneumonitis at the time of BAL had significantly higher (p<0.05) alveolar CD4 subset cells (24.8+/-10.2%) than asymptomatic patients (15.2+/-8.9%). Maximal reductions in total lung capacity (p<0.01), and residual volume (p<0.05) occurred 60 days after irradiation. The early lymphocytic alveolitis induced by unilateral thoracic radiotherapy in most patients with breast cancer is always bilateral and does not predict the subsequent development of radiological evidence of pneumonitis.

This article has been cited by other articles:

				J-F. Cordier Cryptogenic organising pneumonia. Eur. Respir. J., August 1, 2006; 28(2): 422 - 446. [Abstract] [Full Text] [PDF]

				D. Arpin, D. Perol, J.-Y. Blay, L. Falchero, L. Claude, S. Vuillermoz-Blas, I. Martel-Lafay, C. Ginestet, L. Alberti, D. Nosov, et al. Early Variations of Circulating Interleukin-6 and Interleukin-10 Levels During Thoracic Radiotherapy Are Predictive for Radiation Pneumonitis J. Clin. Oncol., December 1, 2005; 23(34): 8748 - 8756. [Abstract] [Full Text] [PDF]

				H. A. Hassaballa, E. S. Cohen, A. J. Khan, A. Ali, P. Bonomi, and D. B. Rubin Positron Emission Tomography Demonstrates Radiation-Induced Changes to Nonirradiated Lungs in Lung Cancer Patients Treated With Radiation and Chemotherapy Chest, September 1, 2005; 128(3): 1448 - 1452. [Abstract] [Full Text] [PDF]

				V. Cottin, R. Frognier, H. Monnot, A. Levy, P. DeVuyst, J-F. Cordier, and and the Groupe d'Etudes et de Recherche sur les Ma Chronic eosinophilic pneumonia after radiation therapy for breast cancer Eur. Respir. J., January 1, 2004; 23(1): 9 - 13. [Abstract] [Full Text] [PDF]

				H. Takahashi, Y. Imai, T. Fujishima, M. Shiratori, S. Murakami, H. Chiba, H. Kon, Y. Kuroki, and S. Abe Diagnostic significance of surfactant proteins A and D in sera from patients with radiation pneumonitis Eur. Respir. J., March 1, 2001; 17(3): 481 - 487. [Abstract] [Full Text] [PDF]

				G. Rolla, U. Ricardi, P. Colagrande, D. Nassisi, L. Dutto, G. Chiavassa, and C. Bucca Changes in Airway Responsiveness Following Mantle Radiotherapy for Hodgkin's Disease Chest, June 1, 2000; 117(6): 1590 - 1596. [Abstract] [Full Text] [PDF]

				J.-F. Cordier Rare diseases bullet 8: Organising pneumonia Thorax, April 1, 2000; 55(4): 318 - 328. [Full Text]