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CT-pathology correlation of amiodarone lung
H Ren1, J E Kuhlman, R H Hruban
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Journal of Computer Assisted Tomography
|September 1, 1990
Summary
Amiodarone therapy can cause lung changes, specifically thickening of septal and pleural lines. High-resolution CT (HRCT) revealed these changes are linked to foam cell accumulation in the lungs.
Area of Science:
- Pulmonary Medicine
- Radiology
- Pathology
Background:
- Amiodarone is a widely used antiarrhythmic drug.
- Drug-induced lung injury is a known complication of amiodarone therapy.
- The specific imaging findings and underlying pathology of amiodarone-induced lung disease require further elucidation.
Purpose of the Study:
- To investigate the high-resolution computed tomography (HRCT) findings in lungs from patients treated with amiodarone.
- To correlate HRCT findings with gross and histologic changes.
- To identify the cellular basis for observed HRCT abnormalities.
Main Methods:
- Postmortem HRCT was performed on 11 explanted lungs from amiodarone-treated patients and 22 control lungs.
- Lungs were inflation-fixed and air-dried prior to HRCT examination.
- HRCT findings were directly correlated with gross and histologic examination, focusing on septal and pleural thickening and cellular changes.
Main Results:
- Significant intralobular septal thickening and visceral pleural thickening were observed on HRCT in amiodarone-treated lungs compared to controls (p < 0.05).
- These HRCT findings were directly associated with the presence of mural foam cells and intraalveolar foam cells.
- The severity of HRCT abnormalities correlated with the degree of foam cell accumulation.
Conclusions:
- Postmortem HRCT can detect characteristic lung abnormalities in patients treated with amiodarone.
- Amiodarone therapy appears to induce the accumulation of mural and intraalveolar foam cells in the lungs.
- Foam cell accumulation is likely responsible for the observed septal and pleural thickening on HRCT, contributing to amiodarone-induced lung disease.