High-resolution CT of drug-induced lung disease

Drug-induced lung injury is a common cause of acute and chronic lung disease. Diagnosis often is difficult and usually is based on a history of drug therapy and exclusion of infection, radiation pneumonitis, and recurrence of the underlying disease. Early diagnosis of drug-induced lung injury is important because injury can be progressive and fatal, whereas cessation of therapy can result in reversal. Knowledge of the most common high-resolution CT (HRCT) manifestations of drug-induced injury can facilitate diagnosis and institution of appropriate treatment. This article reviews the common histopathologic manifestations of drug-induced lung injury including diffuse alveolar damage, nonspecific interstitial pneumonia, bronchiolitis obliterans organizing pneumonia, eosinophilic pneumonia, and pulmonary hemorrhage, as well as the corresponding HRCT manifestations and the drugs most frequently involved.