Unusual thoracic radiographic findings in children treated for Hodgkin's disease.

Abstract

Mantle irradiation is often part of the treatment for Hodgkin's disease. Localized pneumonitis and fibrosis are well-known sequelae of this treatment. We report nine patients with unusual thoracic radiographic findings following treatment for Hodgkin's disease. All nine had mediastinal widening. Seven of these patients received combined modality therapy in which prednisone was given with their MOPP. In these seven patients, an increase in mediastinal width developed at the same time as the radiographic changes of radiation pneumonitis. Two patients developed bilateral infiltrates extending beyond the field of radiation to the lung periphery. In one of these patients, a spontaneous pneumomediastinum developed. One patient underwent mediastinal biopsy that revealed inflammatory changes similar to those seen in radiation pneumonitis. All patients either responded to steroids or had spontaneous regression of radiographic abnormalities supporting the presumed diagnosis of treatment related changes. Recognition of these unusual sequelae of mantle irradiation will aid in differentiating them from infection or tumor and lead to prompt, appropriate treatment.

• Authors: M S Jochelson, N J Tarbell, H J Weinstein
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 4 Issue 6 Pg. 874-82 (Jun 1986) ISSN: 0732-183X [Print] United States
• PMID: 3754886 (Publication Type: Case Reports, Journal Article)

Chemical References

• Procarbazine
• Mechlorethamine
• Vincristine
• Prednisone

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Child
• Combined Modality Therapy
• Female
• Hodgkin Disease (drug therapy, radiotherapy, therapy)
• Humans
• Longitudinal Studies
• Lung (diagnostic imaging)
• Male
• Mechlorethamine (administration & dosage)
• Mediastinal Emphysema (etiology)
• Mediastinum (pathology, radiation effects)
• Middle Aged
• Pneumonia (prevention & control)
• Prednisone (administration & dosage, therapeutic use)
• Procarbazine (administration & dosage)
• Radiography
• Radiotherapy (adverse effects)
• Radiotherapy Dosage
• Vincristine (administration & dosage)