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Unilateral lung hyperlucency after mediastinal irradiation.

M L Wencel1, R G Sitrin

  • 1Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0360.

The American Review of Respiratory Disease
|April 1, 1988
PubMed
Summary

Mediastinal irradiation for Hodgkin's disease can cause a rare complication: unilateral hyperlucent lung. This condition, appearing years later, involves reduced pulmonary blood flow and atrophy of the pulmonary artery in one lung.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Oncology

Background:

  • Mediastinal irradiation is a common treatment for Hodgkin's disease.
  • Late complications of radiation therapy can affect pulmonary vasculature.
  • Understanding these complications is crucial for long-term patient management.

Observation:

  • A 39-year-old woman presented with progressive exertional dyspnea 13 years post-mediastinal irradiation for Hodgkin's disease.
  • Initial chest roentgenogram revealed a hyperlucent right lung.
  • Ventilation-perfusion scanning demonstrated markedly reduced pulmonary blood flow to the right lung.

Findings:

  • Pulmonary angiography confirmed attenuation and diffuse atrophy of the right pulmonary artery and its branches.
  • The findings are consistent with radiation-induced pulmonary vascular damage.

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  • This represents a late-onset, uncommon manifestation of mediastinal irradiation.

    • Implications:

    • This case highlights the importance of long-term surveillance for patients treated with mediastinal irradiation.
    • It underscores the potential for delayed vascular complications following radiation therapy.
    • Awareness of this rare complication can aid in timely diagnosis and management of exertional dyspnea in survivors of Hodgkin's disease.