Lung cancer follow-up: nonmalignant complications

Lung cancer follow-up: nonmalignant complications Award: Certificate of Merit Poster No.: C-1496 Congress: ECR 2011 Type: Educational Exhibit Authors: F. Novell Teixido, M. Andreu, E. Castañer González, X. 1 1 1 2 1 2 2 Gallardo, J. Andreu, O. Persiva Morenza, J. Cáceres, J. M. 1 1 2 Mata Duaso ; Sabadell/ES, Barcelona/ES Keywords: Lung, Thorax, CT, Digital radiography, Drugs / Reactions DOI: 10.1594/ecr2011/C-1496 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. www.myesr.org Page 1 of 46

Learning objectives To review the nonmalignant thoracic complications that can occur after surgery, chemotherapy, and radiotherapy in the follow-up of patients with lung cancer and to describe their appearance on plain-film and CT studies. Page 2 of 46

Background Radiologists need to be aware of the wide spectrum of complications, mainly related to treatment, that could be found in the follow-up of patients with lung cancer. Pulmonary resection is often followed by postoperative complications that differ according to the type of surgery and the time since surgery was performed. Adverse drug reactions due to antineoplastic agents are common, about 10% of patients develop pulmonary toxicity. There is a known increased risk of venous thromboembolism in oncology patients (the risk depends on the tumor type, stage, and treatment with antineoplastic agents), and also arterial thromboembolic events have been described associated with some chemotherapy agents such as cisplatin based and vascular endothelial growth factor receptor. Page 3 of 46

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Imaging findings OR Procedure details We will review the following complications: Postsurgical complications (late postoperative period): bronchopleural fistula, esophagopleural fistula, in situ thrombosis (pulmonary arterial stump), empyema, right postpneumonectomy syndrome, lymphocele, chylothorax. Thrombotic disease (pulmonary arteries, systemic arteries). Radiation-induced complications: fibrosis, pulmonary or bronchial necrosis, organizing pneumonia, cardiovascular disease, pleuropericardial disease. Chemotherapy-induced complications (including new targeted therapy): infections, interstitial lung disease, pulmonary necrosis, esophageal changes. Page 5 of 46

Fig. 1: Echogenic liquid moving with respiratory movements from the postpneumectomy space into the chest wall Page 8 of 46

Conclusion Knowledge of the imaging features of injuries related to treatment is essential to prevent misinterpretation as recurrent tumor, infection, or other processes. It is also important to know the clinical relevance of some incidental findings. Page 42 of 46

Personal Information Page 44 of 46

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