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Drug and Radiation Toxicity

  • Anthony A. Gal

Abstract

Virtually all therapies of modern medicine carry the potential for harm, which may be unpredictable, and lead to long-term consequences. Most drug reactions and radiation injuries are relatively mild, seldom lead to significant morbidity or mortality, and are diagnosed and treated without the necessity of an invasive biopsy procedure. When the clinical presentation is unusual or other problematic circumstances arise, the evaluation of lung tissue becomes necessary to distinguish iatrogenic injury from other entities in the differential diagnosis such as infection, metastatic or recurrent neoplasia, or underlying disease. This chapter reviews the characteristic clinical and morphologic features of the more common manifestations of drug and radiation injury to the lungs.

Keywords

Pulmonary Edema Pulmonary Fibrosis Radiation Pneumonitis Hypersensitivity Pneumonitis Bronchiolitis Obliterans 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Camus P, Bonniaud P, Fanton A, et al. Drug-induced and iatrogenic infiltrative lung disease. Clin Chest Med 2004;25:479–519.PubMedCrossRefGoogle Scholar
  2. 2.
    Travis WD, Colby TV, Koss MN, et al. Drug and radiation reactions. In: Atlas of non-tumor pathology: non-neoplastic disorders of the lower respiratory tract. Washington, DC: American Registry of Pathology, 2002:321–350.Google Scholar
  3. 3.
    Flieder DB, Travis WD. Pathologic characteristics of drug-induced lung disease. Clin Chest Med 2004;25:37–45.PubMedCrossRefGoogle Scholar
  4. 4.
    Limper AH. Chemotherapy-induced lung disease. Clin Chest Med 2004;25:53–64.PubMedCrossRefGoogle Scholar
  5. 5.
    Irey NS. Tissue reactions to drugs. Am J Pathol 1976;82:613–647.PubMedGoogle Scholar
  6. 6.
    Camus P. Drug-induced infiltrative lung disease. In: Schwarz MI, King TE, eds. Interstitial lung disease. Hamilton, Ontario: BC Decker 2002:485–534.Google Scholar
  7. 7.
    Pietra GG. Pathologic mechanisms of drug-induced lung disorders. J Thorac Imaging 1991;6:1–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Lombard CM. Drug-induced pulmonary disease. In: Saldana MJ, ed. Pathology of pulmonary disease. Philadelphia: JB Lippincott, 1994:149–157.Google Scholar
  9. 9.
    Cooper JA Jr. Drug-induced lung disease. Adv Intern Med 1997;42:231–268.Google Scholar
  10. 10.
    Rossi SE, Erasmus JJ, McAdams HP, et al. Pulmonary drug toxicity: radiologic and pathologic manifestations. Radiographics 2000;20:1245–1259.PubMedGoogle Scholar
  11. 11.
    Pneumotox Web site: http://www.pneumotox.com.Google Scholar
  12. 12.
    Smith GJW. The histopathology of pulmonary reactions to drugs. Clin Chest Med 1990;11:95–117.PubMedGoogle Scholar
  13. 13.
    Bedrossian CWM. Pathology of drug-induced lung diseases. Semin Respir Med 1982;4:98–105.CrossRefGoogle Scholar
  14. 14.
    Myers JL. Pathology of drug-induced lung disease. In: Katzenstein ALA, ed. Katzenstein and Askin’s surgical pathology of non-neoplastic lung disease. 3rd ed. Philadelphia: WB Saunders, 1997:81–111.Google Scholar
  15. 15.
    Kendall DM, Gal AA. Interpretation of tissue artifacts in transbronchial lung biopsy specimens. Ann Diagn Pathol 2003;7:20–24.PubMedCrossRefGoogle Scholar
  16. 16.
    Babu KS, Marshall BG. Drug-induced airway diseases. Clin Chest Med 2004;25:113–122.PubMedCrossRefGoogle Scholar
  17. 17.
    DeSwarte RD. Drug allergy: an overview. Clin Rev Allergy 1986;4:143–169.PubMedGoogle Scholar
  18. 18.
    Ligresti DJ. Anaphylaxis. Clin Dermatol 1986;4:40–49.PubMedCrossRefGoogle Scholar
  19. 19.
    Shkutin AE, Naresheva KA, Donchenko VS. Morphology and pathogenesis of changes in the lungs during drug-induced anaphylactic shock in humans. Arkh Patol 1989;51:48–54.PubMedGoogle Scholar
  20. 20.
    Meeker DP, Wiedemann HP. Drug-induced bronchospasm. Clin Chest Med 1990;11:163–175.PubMedGoogle Scholar
  21. 21.
    Lock BJ, Eggert M, Cooper JA Jr. Infiltrative lung disease due to noncytotoxic agents. Clin Chest Med 2004;25:47–52.PubMedCrossRefGoogle Scholar
  22. 22.
    Ameisen JC, Capron A. Aspirin-sensitive asthma. Clin Exp Allergy 1990;20:127–129.PubMedCrossRefGoogle Scholar
  23. 23.
    Slepian IK, Mathews KP, McLean JA. Aspirin-sensitive asthma. Chest 1985;87:386–391.PubMedCrossRefGoogle Scholar
  24. 24.
    Spector SL, Wangarrd CH, Farr RS. Aspirin and concomitant idiosyncrasies in adult asthmatic patients. J Allergy Clin Immunol 1979;64:500–506.PubMedCrossRefGoogle Scholar
  25. 25.
    Szceklik A, Nizankowska E, Czerniawska-Mysik G, et al. Hydrocortisone and airflow impairment in aspirin-induced asthma. J Allergy Clin Immunol 1985;76:530–536.CrossRefGoogle Scholar
  26. 26.
    Lama PJ. Systemic adverse effects of beta-adrenergic blockers: an evidence-based assessment. Am J Ophthalmol 2002;134:749–760.PubMedCrossRefGoogle Scholar
  27. 27.
    Beemer GH, Dennis WL, Platt PR, et al. Adverse reactions to atracurium and alcuronium. Br J Anaesth 1988;61:680–684.PubMedCrossRefGoogle Scholar
  28. 28.
    Morcos SK. Effects of radiographic contrast media on the lung. Br J Radiol 2003;6:290–295.CrossRefGoogle Scholar
  29. 29.
    Bertrand P, Rouleau P, Alison D, et al. Use of peak expiratory flow rate to identify patients with increased risk of contrast medium reaction. Results of preliminary study. Invest Radiol 1988;23:5203–5205.Google Scholar
  30. 30.
    Littner MR, Ulreich S, Putman CE, et al. Bronchospasm during excretory urography. Lack of specificity for the methylglucamine cation. AJR 1981;137:477–481.PubMedCrossRefGoogle Scholar
  31. 31.
    Kozlowski C, Kollef MH. Noncardiogenic pulmonary edema associated with intravenous radiocontrast administration. Chest 1992;102:620–621.PubMedCrossRefGoogle Scholar
  32. 32.
    Yarbrough J, Mansfield LE, Ting S. Metered dose inhaler-induced bronchospasm in asthmatic patients. Ann Allergy 1985;55:25–27.PubMedGoogle Scholar
  33. 33.
    Cocchetto DM, Sykes RS, Spector S. Paradoxical bronchospasm after use of inhalation aerosols: a review of the literature. J Asthma 1991;28:49–53.PubMedCrossRefGoogle Scholar
  34. 34.
    Montgomery AB, Debs RJ, Luce JM, et al. Aerosolised pentamidine as sole therapy for Pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome. Lancet 1987;8557:480–483.CrossRefGoogle Scholar
  35. 35.
    Acute pulmonary effects of aerosolized pentamidine. A randomized controlled study. Toronto Aerosolized Pentamidine Study (TAPS) Group. Chest 1990;98:907–910.Google Scholar
  36. 36.
    Lee-Chiong T Jr, Matthay RA. Drug-induced pulmonary edema and acute respiratory distress syndrome. Clin Chest Med 2004;25:95–104.PubMedCrossRefGoogle Scholar
  37. 37.
    Heffner JE, Sahn SA. Salicylate-induced pulmonary edema. Clinical features and prognosis. Ann Intern Med 1981;95:405–409.PubMedCrossRefGoogle Scholar
  38. 38.
    Steinberg AD, Karliner JS. The clinical spectrum of heroin pulmonary edema. Arch Intern Med 1968;122:122–127.PubMedCrossRefGoogle Scholar
  39. 39.
    Darke S, Zador D. Fatal heroin “overdose”: a review. Addiction 1996;91:1765–1772.PubMedCrossRefGoogle Scholar
  40. 40.
    Atkins MB. Interleukin-2: clinical applications. Semin Oncol 2002;29(3, suppl 7):12–17.PubMedCrossRefGoogle Scholar
  41. 41.
    Abid SH, Malhotra V, Perry MC. Radiation-induced and chemotherapy-induced pulmonary injury. Curr Opin Oncol 2001;13:242–248.PubMedCrossRefGoogle Scholar
  42. 42.
    Saxon RR, Klein JS, Bar MH, et al. Pathogenesis of pulmonary edema during interleukin-2 therapy: correlation of chest radiographic and clinical findings in 54 patients. AJR 1991;156:281–286.PubMedCrossRefGoogle Scholar
  43. 43.
    Huggins JT, Sahn SA. Drug-induced pleural disease. Clin Chest Med. 2004;25:141–153.PubMedCrossRefGoogle Scholar
  44. 44.
    Pisani RJ, Rosenow EC 3rd. Pulmonary edema associated with tocolytic therapy. Ann Intern Med 1989;110:714–718.PubMedCrossRefGoogle Scholar
  45. 45.
    Webert KE, Blajchman MA. Transfusion-related acute lung injury. Transfus Med Rev 2003;17:252–262.PubMedCrossRefGoogle Scholar
  46. 46.
    Kopko PM, Popovsky MA. Pulmonary injury from transfusion-related acute lung injury. Clin Chest Med 2004;25:105–111.PubMedCrossRefGoogle Scholar
  47. 47.
    Roberts GH. Transfusion-related acute lung injury (TRALI). Clin Lab Sci 2004;17:133–135.PubMedGoogle Scholar
  48. 48.
    Holness L, Knippen MA, Simmons L, et al. Fatalities caused by TRALI. Transfus Med Rev 2004;18:184–188.PubMedCrossRefGoogle Scholar
  49. 49.
    Tomashefski JF Jr. Pulmonary pathology of acute respiratory distress syndrome. Clin Chest Med 2000;21:435–466.PubMedCrossRefGoogle Scholar
  50. 50.
    American Thoracic Society. American Thoracic Society/European Respiratory Society international multidisciplinary consensus classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 2002;165:277–304.CrossRefGoogle Scholar
  51. 51.
    Epler G. Drug-induced bronchiolitis obliterans organizing pneumonia. Clin Chest Med 2004;25:89–94.PubMedCrossRefGoogle Scholar
  52. 52.
    Myers JL, Colby TV. Pathologic manifestations of bronchiolitis, constrictive bronchiolitis, cryptogenic organizing pneumonia, and diffuse panbronchiolitis. Clin Chest Med 1993;14:611–622.PubMedGoogle Scholar
  53. 53.
    Schlesinger C, Veeraraghavan S, Koss MN. Constrictive (obliterative) bronchiolitis. Curr Opin Pulmon Med 1998;4:288–293.CrossRefGoogle Scholar
  54. 54.
    Allen JN. Drug-induced eosinophilic lung disease. Clin Chest Med 2004;25:77–88.PubMedCrossRefGoogle Scholar
  55. 55.
    Yousem SA. Eosinophilic pneumonia-like areas in idiopathic usual interstitial pneumonia. Mod Pathol 2000;13:1280–1284.PubMedCrossRefGoogle Scholar
  56. 56.
    Wechsler ME, Garpestad E, Flier SR, et al. Pulmonary infiltrates, eosinophilia, and cardiomyopathy following corticosteroid withdrawal in patients with asthma receiving zafirlukast. JAMA 1998;279:455–457.PubMedCrossRefGoogle Scholar
  57. 57.
    Weller PF, Plaut M, Taggart V, et al. The relationship of asthma therapy and Churg-Strauss syndrome: NIH workshop summary report. J Allergy Clin Immunol 2001;108:175–183.PubMedCrossRefGoogle Scholar
  58. 58.
    Gal AA, Morris RJ, Pine JR, et al. Cutaneous lesions of Churg-Strauss syndrome associated with montelukast therapy. Br J Dermatol 2002;147:618–619.PubMedCrossRefGoogle Scholar
  59. 59.
    Coleman A, Colby TV. Histologic diagnosis of extrinsic allergic alveolitis. Am J Surg Pathol 1988;2:514–518.CrossRefGoogle Scholar
  60. 60.
    Marzouk K, Saleh S, Kannass M, et al. Interferon-induced granulomatous lung disease. Curr Opin Pulmon Med 2004;10:435–440.CrossRefGoogle Scholar
  61. 61.
    Schwarz MI, Fontenot AP. Drug-induced diffuse alveolar hemorrhage syndromes and vasculitis. Clin Chest Med 2004;25:133–140.PubMedCrossRefGoogle Scholar
  62. 62.
    Sternlieb I, Bennett B, Scheinberg IH. D-penicillamine induced Goodpasture’s syndrome in Wilson’s disease. Ann Intern Med 1975;82:673–676.PubMedCrossRefGoogle Scholar
  63. 63.
    Higenbottam T, Laude L, Emery C, et al. Pulmonary hypertension as a result of drug therapy. Clin Chest Med 2004;25:123–131.PubMedCrossRefGoogle Scholar
  64. 64.
    Gurtner HP. Pulmonary hypertension, “plexogenic pulmonary arteriopathy” and the appetite depressant drug aminorex: post or propter? Bull Eur Physiopathol Respir 1979;15:897–923.PubMedGoogle Scholar
  65. 65.
    Mark EJ, Patalas ED, Chang HT, et al. Fatal pulmonary hypertension associated with short-term use of fenfluramine and phentermine. N Engl J Med 1997;337:602–606.PubMedCrossRefGoogle Scholar
  66. 66.
    Rich S, Rubin L, Walker AM, et al. Anorexigens and pulmonary hypertension in the United States: results from the surveillance of North American pulmonary hypertension. Chest 2000;117:870–874.PubMedCrossRefGoogle Scholar
  67. 67.
    Tomashefski JF, Hirsch CS. The pulmonary vascular lesions of intravenous drug abuse. Hum Pathol 1980;11:133–145.PubMedCrossRefGoogle Scholar
  68. 68.
    Ellis DA, Capewell SJ. Pulmonary veno-occlusive disease after chemotherapy. Thorax 1986;41:415–416.PubMedCrossRefGoogle Scholar
  69. 69.
    Lombard CM, Churg A, Winokur S. Pulmonary veno-occlusive disease following therapy for malignant neoplasms. Chest 1987;92:871–876.PubMedCrossRefGoogle Scholar
  70. 70.
    Presneill JJ, Nakata K, Inoue Y, et al. Pulmonary alveolar proteinosis. Clin Chest Med 2004;25:593–613.PubMedCrossRefGoogle Scholar
  71. 71.
    Bedrossian CW, Luna MA, Conklin RH, et al. Alveolar proteinosis as a consequence of immunosuppression. A hypothesis based on clinical and pathologic observations. Hum Pathol 1980;11(5 suppl):527–535.PubMedGoogle Scholar
  72. 72.
    Aymard JP, Gyger M, Lavallee R, et al. A case of pulmonary alveolar proteinosis complicating chronic myelogenous leukemia. A peculiar pathologic aspect of busulfan lung? Cancer 1984;53:954–956.PubMedCrossRefGoogle Scholar
  73. 73.
    Rubin RL. Etiology and mechanisms of drug-induced lupus. Curr Opin Rheumatol 1999;11:357–363.PubMedCrossRefGoogle Scholar
  74. 74.
    Antonov D, Kazandjieva J, Etugov D, et al. Drug-induced lupus erythematosus. Clin Dermatol 2004;22:157–166.PubMedCrossRefGoogle Scholar
  75. 75.
    Hess EV. Drug-related lupus: The same or different? In: Lahita RG, ed. Systemic lupus erythematosus. New York: Wiley, 1987:869–880.Google Scholar
  76. 76.
    Hindle W, Posner E, Sweetnam MT, et al. Pleural effusion and fibrosis during treatment with methysergide. Br Med J 1970;1:605–606.PubMedCrossRefGoogle Scholar
  77. 77.
    Martin WJ 2nd, Rosenow EC 3rd. Amiodarone pulmonary toxicity. Recognition and pathogenesis (part 2). Chest 1988;93:1242–1248.PubMedCrossRefGoogle Scholar
  78. 78.
    Kennedy JI Jr. Clinical aspects of amiodarone pulmonary toxicity. Clin Chest Med 1990;11:119–129.PubMedGoogle Scholar
  79. 79.
    Fraire AE, Guntupalli KK, Greenberg SD, et al. Amiodarone pulmonary toxicity: a multidisciplinary review of current status. South Med J 1993;86:67–77.PubMedCrossRefGoogle Scholar
  80. 80.
    Camus P, Martin WJ, Rosenow EC. Amiodarone pulmonary toxicity. Clin Chest Med 2004;25:65–75.PubMedCrossRefGoogle Scholar
  81. 81.
    Myers JL, Kennedy JI, Plumb VJ. Amiodarone lung: pathologic findings in clinically toxic patients. Hum Pathol 1987;18:349–354.PubMedCrossRefGoogle Scholar
  82. 82.
    Dean PJ, Groshart KD, Porterfield JG, et al. Amiodarone-associated pulmonary toxicity. A clinical and pathologic study of eleven cases. Am J Clin Pathol 1987;87:7–13.PubMedGoogle Scholar
  83. 83.
    Coudert B, Bailly F, Lombard JN, et al. Amiodarone pneumonitis. Bronchoalveolar lavage findings in 15 patients and review of the literature. Chest 1992;102:1005–1012.PubMedCrossRefGoogle Scholar
  84. 84.
    Ohar JA, Jackson F, Dettenmeier PA, et al. Bronchoalveolar lavage cell count and differential are not reliable indicators of amiodarone-induced pneumonitis. Chest 1992;102:999–1004.PubMedCrossRefGoogle Scholar
  85. 85.
    Colgan T, Simon GT, Kay JM, et al. Amiodarone pulmonary toxicity. Ultrastruct Pathol 1984;6:199–207.PubMedCrossRefGoogle Scholar
  86. 86.
    Santrach PJ, Askin FB, Wells RJ, et al. Nodular form of bleomycin-related pulmonary injury in patients with osteogenic sarcoma. Cancer 1989;64:806–811.PubMedCrossRefGoogle Scholar
  87. 87.
    Holoye PY, Luna MA, MacKay B, et al. Bleomycin hypersensitivity pneumonitis. Ann Intern Med 1978;88:47–49.PubMedCrossRefGoogle Scholar
  88. 88.
    White DA, Schwartzberg LS, Kris MG, et al. Acute chest pain syndrome during bleomycin infusions. Cancer 1987;59:1582–1585.PubMedCrossRefGoogle Scholar
  89. 89.
    Oliner H, Schwartz R, Rubio F, et al. Interstitial pulmonary fibrosis following busulfan therapy. Am J Med 1961;31:134–139.PubMedCrossRefGoogle Scholar
  90. 90.
    Twohig KJ, Matthay RA. Pulmonary effects of cytotoxic agents other than bleomycin. Clin Chest Med 1990;11:31–54.PubMedGoogle Scholar
  91. 91.
    Weiss RB, Poster DS, Penta JS. The nitrosoureas and pulmonary toxicity. Cancer Treat Rev 1981;8:111–125.PubMedCrossRefGoogle Scholar
  92. 92.
    Smith AC. The pulmonary toxicity of nitrosoureas. Pharmacol Ther 1989;44:443–460.CrossRefGoogle Scholar
  93. 93.
    Massin F, Coudert B, Foucher P, et al. Nitrosourea-induced lung diseases. Rev Mal Respir 1992;9:575–582.PubMedGoogle Scholar
  94. 94.
    O’Driscoll BR, Hasleton PS, Taylor PM, et al. Active lung fibrosis up to 17 years after chemotherapy with car-mustine (BCNU) in childhood: N Engl J Med 1990;323:378–382.PubMedCrossRefGoogle Scholar
  95. 95.
    O’Driscoll BR, Kalra S, Gattamaneni HR, et al. Late car-mustine lung fibrosis. Age at treatment may influence severity and survival. Chest 1995;107:1355–1357.PubMedCrossRefGoogle Scholar
  96. 96.
    Malik SW, Myers JL, DeRemee RA, et al. Lung toxicity associated with cyclo-phosphamide use. Two distinct patterns. Am J Respir Crit Care Med 1996;154:1851–1856.PubMedCrossRefGoogle Scholar
  97. 97.
    Segura A, Yuste A, Cercos A, et al. Pulmonary fibrosis induced by cyclophosphamide. Ann Pharmacother 2001;35:894–897.PubMedCrossRefGoogle Scholar
  98. 98.
    Alarcon GS, Kremer JM, Macaluso M, et al. Risk factors for methotrexate-induced lung injury in patients with rheumatoid arthritis. A multicenter, case-control study. Methotrexate-Lung Study Group. Ann Intern Med 1997;127:356–364.PubMedCrossRefGoogle Scholar
  99. 99.
    Sostman HD, Matthay RA, Putman CE, et al. Methotrexate-induced pneumonitis. Medicine (Baltimore) 1976;55:371–388.PubMedCrossRefGoogle Scholar
  100. 100.
    Kremer JM, Alarcon GS, Weinblatt ME, et al. Clinical, laboratory, radiographic, and histopathologic features of methotrexate-associated lung injury in patients with rheumatoid arthritis: a multicenter study with literature review. Arthritis Rheum 1997;40:1829–1837.PubMedCrossRefGoogle Scholar
  101. 101.
    Imokawa S, Colby TV, Leslie KO, et al. Methotrexate pneumonitis: review of the literature and histo-pathological findings in nine patients. Eur Respir J 2000;15:373–381.PubMedCrossRefGoogle Scholar
  102. 102.
    Bedrossian CWM, Miller WC, et al. Methotrexate-induced diffuse interstitial pulmonary fibrosis. South Med J 1979;72:313–318.PubMedCrossRefGoogle Scholar
  103. 103.
    Kaplan RL, Waite DH. Progressive interstitial lung disease from prolonged methotrexate therapy. Arch Dermatol 1978;114:1800–1802.PubMedCrossRefGoogle Scholar
  104. 104.
    Gunstream SR, Seidenfeld JJ, Sobonya RE, et al. Mitomy-cin-associated lung disease. Cancer Treat Rep 1983;67:301–304.PubMedGoogle Scholar
  105. 105.
    Jolivet J, Giroux L, Laurin S, Gruber J, et al. Microangiopathic hemolytic anemia, renal failure, and noncardiogenic pulmonary edema: a chemotherapy-induced syndrome. Cancer Treat Rep 1983;67:429–434.PubMedGoogle Scholar
  106. 106.
    Chang-Poon VY, Hwang WS, Wong A, et al. Pulmonary angiomatoid vascular changes in mitomycin C-associated hemolytic-uremic syndrome. Arch Pathol Lab Med 1985;109:877–878.PubMedGoogle Scholar
  107. 107.
    Holmberg L, Boman G. Pulmonary reactions to nitrofurantoin. Eur J Respir Dis 1981;62:180–189.PubMedGoogle Scholar
  108. 108.
    Sovijarvi AR, Lemola M, Stenius B, et al. Nitrofurantoin-induced acute, subacute and chronic pulmonary reactions. Scand J Respir Dis 1977;58:41–50.PubMedGoogle Scholar
  109. 109.
    Geller M, Dickie HA, Kass DA, et al. The histopathology of acute nitrofurantoin-associated pneumonitis. Ann Allergy 1976;37:275–279.PubMedGoogle Scholar
  110. 110.
    Nonn RA, Gross NX Effects of radiation on the lung. Curr Opin Pulmon Med 1996;2:390–395.CrossRefGoogle Scholar
  111. 111.
    Tomashefski JF Jr. Iatrogenic diffuse alveolar damage: oxygen toxicity and radiation-induced injury. In: Saldana MJ, ed. Pathology of pulmonary disease. Philadelphia: JB Lippincott, 1994:143–147.Google Scholar
  112. 112.
    Movsas B, Raffin TA, Epstein AH, et al. Pulmonary radiation injury. Chest 1997;111:1061–1076.PubMedCrossRefGoogle Scholar
  113. 113.
    Fajardo LF, Berthrong M, Anderson RE, eds. Lung. In: Radiation pathology. Oxford: Oxford University Press, 2001:198–207.Google Scholar
  114. 114.
    Abratt RP, Morgan GW, Silvestri G, et al. Pulmonary complications of radiation therapy. Clin Chest Med 2004;25:167–177.PubMedCrossRefGoogle Scholar
  115. 115.
    Weichselbaum RR, Hallahan DE, Sukhatme V, et al. Biological consequences of gene regulation after ionizing radiation exposure. J Natl Cancer Inst 1991;83:480–488.PubMedCrossRefGoogle Scholar
  116. 116.
    Siemann DW, Rubin P, Penney DP. Pulmonary toxicity following multifraction radiotherapy. Br J Cancer 1986;53(suppl VII):365–367.Google Scholar
  117. 117.
    Rosiello RA, Merrill WW. Radiation-induced lung injury. Clin Chest Med 1990;11:65–71.PubMedGoogle Scholar
  118. 118.
    Fulkerson WJ, Mclendon RE, Prosnitz IR. Adult respiratory distress syndrome after limited thoracic radiotherapy. Cancer 1986;57:1941–1946.PubMedCrossRefGoogle Scholar
  119. 119.
    Byhardt RW, Abrams R, Almagro U. The association of adult respiratory distress syndrome (ARDS) with thoracic irradiation (RT). Int J Radiat Oncol Biol Phys 1988;15:1441–1446.PubMedCrossRefGoogle Scholar
  120. 120.
    O’Sullivan B, Levin W Late radiation-related fibrosis: pathogenesis, manifestations, and current management. Semin Radiat Oncol 2003;13:274–289.PubMedCrossRefGoogle Scholar
  121. 121.
    Smith PG, Doll R. Mortality from cancer and all causes among British radiologists. Br J Radiol 1981;54:187–194.PubMedCrossRefGoogle Scholar
  122. 121.
    Zablotska LB, Angevine AH, Neugut AI. Therapy-induced thoracic malignancies. Clin Chest Med 2004;25:217–224.PubMedCrossRefGoogle Scholar
  123. 123.
    Neugut AI, Murray T, Santos J, et al. Increased risk of lung cancer after breast cancer radiation therapy in cigarette smokers. Cancer 1994;73:1615–1620.PubMedCrossRefGoogle Scholar
  124. 124.
    Travis LB, Curtis RE, Boice JD, et al. Second cancers following non-Hodgkin’s lymphoma. Cancer 1991;67:2002–2009.PubMedCrossRefGoogle Scholar
  125. 125.
    Swerdlow A, Barber JA, Hudson GV, et al. Risk of second malignancy after Hodgkin’s disease in a collaborative British cohort: the relation to age at treatment. J Clin Oncol 2000;18:498.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Anthony A. Gal
    • 1
  1. 1.Department of Pathology and Laboratory MedicineEmory University HospitalAtlantaUSA

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