Radiation-induced lung injury

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Radiation-induced lung injury
Classification and external resources
ICD-10	J 70.0-J 70.1
ICD-9	508.0-508.1
MeSH	D017564

Radiation-induced lung injury is a general term for damage to the lungs which occurs as a result of exposure to ionizing radiation. In general terms, such damage is divided into early inflammatory damage (radiation pneumonitis) and later complications of chronic scarring (radiation fibrosis). Radiation-induced lung injury most commonly occurs as a result of radiation therapy administered to treat cancer.^[1]

The lungs are the most radiosensitive organ, and radiation pneumonitis can occur leading to pulmonary insufficiency and death (100% after exposure to 50 gray of radiation), in a few months.

Radiation pneumonitis is characterized by:^[2]

Loss of epithelial cells
Edema
Inflammation
Occlusions of airways, air sacs and blood vessels
Fibrosis

References

^ Movsas B, Raffin TA, Epstein AH, Link CJ (April 1997). "Pulmonary radiation injury". Chest 111 (4): 1061–76. doi:10.1378/chest.111.4.1061. PMID 9106589. http://www.chestjournal.org/content/111/4/1061.full.pdf.
^ Coggle, J. E.; Lindop, P. J. (1983). "Medical consequences of radiation following a global nuclear war". In Peterson, J.. The Aftermath : the human and ecological consequences of nuclear war. New York: Pantheon Books. pp. 60–71. ISBN 0-394-53446-8.

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Pathology of respiratory system (J, 460–519), respiratory diseases

Upper RT
(including URTIs,
Common cold)

Head	sinuses: Sinusitis nose: Rhinitis (Vasomotor rhinitis, Atrophic rhinitis, Hay fever) · Nasal polyp · Rhinorrhea · nasal septum (Nasal septum deviation, Nasal septum perforation, Nasal septal hematoma) tonsil: Tonsillitis · Adenoid hypertrophy · Peritonsillar abscess

Neck	pharynx: Pharyngitis (Strep throat) · Laryngopharyngeal reflux (LPR) · Retropharyngeal abscess larynx: Croup · Laryngitis · Laryngopharyngeal reflux (LPR) · Laryngospasm vocal folds: Laryngopharyngeal reflux (LPR) · Vocal fold nodule · Vocal cord paresis · Vocal cord dysfunction epiglottis: Epiglottitis trachea: Tracheitis · Tracheal stenosis

Lower RT/lung disease
(including LRTIs)

Bronchial/
obstructive

acute: Acute bronchitis

chronic: COPD (Chronic bronchitis, Acute exacerbations of chronic bronchitis, Acute exacerbation of COPD, Emphysema) · Asthma (Status asthmaticus, Aspirin-induced, Exercise-induced) · Bronchiectasis

unspecified: Bronchitis · Bronchiolitis (Bronchiolitis obliterans) · Diffuse panbronchiolitis

Interstitial/
restrictive
(fibrosis)

External agents/ occupational lung disease	Pneumoconiosis (Asbestosis, Baritosis, Bauxite fibrosis, Berylliosis, Caplan's syndrome, Chalicosis, Coalworker's pneumoconiosis, Siderosis, Silicosis, Talcosis, Byssinosis) Hypersensitivity pneumonitis (Bagassosis, Bird fancier's lung, Farmer's lung, Lycoperdonosis)

Other	ARDS · Pulmonary edema · Löffler's syndrome/Eosinophilic pneumonia · Respiratory hypersensitivity (Allergic bronchopulmonary aspergillosis) Hamman-Rich syndrome · Idiopathic pulmonary fibrosis · Sarcoidosis

Obstructive or
restrictive

Pneumonia/
pneumonitis

By pathogen	Viral · Bacterial (Pneumococcal, Klebsiella) / Atypical bacterial (Mycoplasma, Legionnaires' disease, Chlamydiae) · Fungal (Pneumocystis) · Parasitic · noninfectious (Chemical/Mendelson's syndrome, Aspiration/Lipid)

By vector/route	Community-acquired · Healthcare-associated · Hospital-acquired

By distribution	Broncho- · Lobar

IIP	UIP · DIP · BOOP-COP · NSIP · RB

Other

Atelectasis · circulatory (Pulmonary hypertension, Pulmonary embolism) · Lung abscess

Pleural cavity/
mediastinum

Pleural disease	Pleuritis/pleurisy Pneumothorax/Hemopneumothorax Pleural effusion: Hemothorax · Hydrothorax · Chylothorax · Empyema/pyothorax · Malignant Fibrothorax

Mediastinal disease	Mediastinitis · Mediastinal emphysema

Other/general

Respiratory failure · Influenza · SARS · Idiopathic pulmonary haemosiderosis · Pulmonary alveolar proteinosis

M: RES

anat(n, x, l, c)/phys/devp

noco(c, p)/cong/tumr, sysi/epon, injr

proc, drug(R1/2/3/5/6/7)

v t e Radiation poisoning

General	Accidents · Experiments · Biological timeline

Conditions	Radiation dermatitis · Radiation recall reaction · Radiation acne · Radiation cancer · Radiation-induced lung injury

Treatments	Dose fractionation · Radioresistance · Radiation protection · Radiation dose reconstruction

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