Iatrogenic Conditions

Over a thousand medications are known to have the potential to result in lung injury. The constant development of new pharmaceuticals capable of inducing lung damage has grown to a point where it is a challenge to update the information. Fortunately, a comprehensive catalog can be found in the International Database “Pneumotox” (www.pneumotox.com). In this initiative, the imaging characteristics and/or suspected substance can be thoroughly researched, including common and unusual manifestations. It is important to be aware of the medication groups most likely to be associated with lung injury: antineoplastic drugs, antirheumatic medications, antibiotics, nonsteroidal anti-inflammatory agents (NSAIDs), antipsychotics, and antiarrhythmics. In the oncologic setting, it is important to be familiar with the variety of treatment-related side effects to avoid misinterpretation as tumor progression and to ensure appropriate management. Treatment options include chemotherapy, targeted therapy, immunotherapy, and radiation therapy. While recent advances in high-precision radiation therapy techniques such as stereotactic body radiotherapy (SBRT), intensity-modulated radiotherapy (IMRT), and proton therapy (PT) have decreased the radiation dose to normal tissues during treatment, radiation-induced lung injury usually occurs to some degree.