Gemcitabine lung toxicity

Case contributed by Yaïr Glick
Diagnosis almost certain


Status post-Whipple surgery for ductal adenocarcinoma of pancreatic head. For follow-up.

Patient Data

Age: 65 years
Gender: Male
  • 15 mm thick subcarinal lymph node and borderline-sized right paratracheal node. Bilateral perihilar nodes with maximum thickness of 15 mm.
  • Status post-left upper lobectomy. Right upper lobe centrilobular and paraseptal emphysema. Bilateral cylindrical bronchiectasis and peribronchial cuffing. Large ground glass opacities in both lungs - most probably a manifestation of gemcitabine toxicity.
  • Minuscule amount of right pleural effusion, small amount on left.
  • Status post-pancreaticoduodenectomy, with the anastomoses appearing intact. The pancreatic head and tail are atrophied - a manifestation of pancreatic ductal adenocarcinoma. No evidence of local or distal abdominal lymphadenopathy. Omental and retroperitoneal areas of fat stranding. Fatty liver. Elongated structure in the gallbladder bed, perhaps fat necrosis.
  • Right posterior tracheal diverticulum at the level of the clavicles. Sigmoid, right (not shown) and left colonic diverticula.


Case Discussion

A case of gemcitabine lung toxicity following a Whipple procedure for pancreatic ductal adenocarcinoma of the pancreatic head.

Lung toxicity is a long-known, common side effect of many chemotherapeutic agents. Care must be taken, however, with the diagnosis thereof, as opportunistic lung infections are common in immunosuppressed oncological patients; oftentimes, a lung infection and lung toxicity can have a very similar radiological appearance.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.