Iatrogenic pulmonary lesions.

Area of Science:

• Pulmonology
• Toxicology
• Pathology

Background:

• Patient treatment frequently involves medications and radiation, which can lead to adverse effects.
• While often mild, these effects can be severe, life-threatening, and sometimes permanent.
• Common histopathologic findings include interstitial pneumonia, organizing pneumonia, and diffuse alveolar damage.

Purpose of the Study:

• To highlight the potential for severe lung toxicity from medical treatments.
• To inform clinicians and pathologists about drug-induced lung disease and radiation-related lung injury.
• To emphasize the importance of early diagnosis and intervention.

Main Methods:

• Review of common histopathologic findings in drug-induced interstitial lung disease.
• Identification of drugs and agents associated with lung toxicity (e.g., nitrofurantoin, amiodarone, chemotherapy, immune modulators).
• Discussion of radiation therapy-induced lung toxicity and other potential causes like foreign substances and medical devices.

Main Results:

• Drug-induced lung disease presents with diverse histopathologic patterns.
• Specific drugs like nitrofurantoin, amiodarone, bleomycin, methotrexate, rituximab, and immune checkpoint inhibitors are frequently implicated.
• Radiation therapy and certain medical materials can also cause pulmonary complications.

Conclusions:

• Clinicians and pathologists must consider drug-induced lung toxicity in differential diagnoses.
• Accurate patient drug history is essential for accurate diagnosis.
• Early intervention can prevent the progression of lung damage and permanent sequelae.