Medical image of the week: chemotherapy-induced diffuse alveolar hemorrhage

• Main Authors: Khan S, Jaliawala HA
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2017-11-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: chemotherapy; hemoptysis; chest x-ray; CT scan; consolidation; diffuse; complication; hemorrhage; fludarabine; cytarabine
• Online Access: http://www.swjpcc.com/imaging/2017/11/6/medical-image-of-the-week-chemotherapy-induced-diffuse-alveo.html

No abstract available. Article truncated after 150 words. A 65-year-old man presented with relapse of his acute myeloid leukemia (AML). On admission he was seen to have a reduced ejection fraction at 40-50%. His chest X-ray showing pulmonary edema and bilateral pleural effusions (Figure 1A). He was diuresed to his dry weight to improve his clinical status. The decision was made to re-induce him for his AML with fludarabine and cytarabine without idarubicin (due to his reduced ejection fraction). After 2 doses of each the fludarabine and cytarabine the patient showed worsening respiratory distress, had increasing oxygen requirements and started having hemoptysis. Repeat imaging of his chest showed bilateral infiltrates in his lungs on both chest x-ray (Figure 1B) and chest CT (Figure 2). Infectious causes for the changes were sought and ruled out. He was transferred to the ICU where he was put on high flow oxygen and received methylprednisolone 1000 mg IV daily for 3 days. …