Radiation pulmonary fibrosis and superior vena caval obstruction

Case contributed by Azza Elgendy
Diagnosis almost certain

Presentation

Known lung cancer received radiotherapy.

Patient Data

Age: 65 years
Gender: Male
This study is a stack
Coronal
lung window
This study is a stack
Axial C+
arterial phase
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Info

Right upper lobe lung cancer, status post mass resection and radiation therapy, shows right apical architectural distortion, fibrosis, ground glass opacity and consolidation that conforms to the radiation portal.

Bilateral paramediastinal soft tissue fullness associated with SVC obstruction from radiation. 

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SVC obstruction, narrow lumen with lack of enhancement.

Case Discussion

Radiation pneumonitis implies a ground glass opacity and/or consolidation in context of a clinical pneumonia, whilst in radiation fibrosis is architectural distortion, traction bronchiectasis and fibrosis. This case shows both interstitial pneumonitis and interstitial fibrosis associated with SVC obstruction. 

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