To recognize the main features of chemotherapy-induced infiltrative lung disease as seen on High Resolution Computed Tomography (HRCT). To review cases of chemotherapy induced infiltrative lung disease.

Chemotherapeutic agents are extensively used in solid and hematologic malignancies. Increasing number of drugs are associated with infiltrative lung disease. Their occurance is hard to predict. No detailed overall study of the incidence is available.Diagnosis is difficult because of the pre-existing lung lesions and the lack of specific clinical, imaging, bronchoalveolar or histopathologic features. Clinical and radiographic findings may be similar to pulmonary infection, embolism and tumor progression. Early recognition and prompt management are essential because of the variable clinical severity.

The mode of onset of chemotherapy-induced lung disease can be acute or insidious. Timing of clinical manifestations is variable andranges from hours toyears after the initial cycle of treatment. Lung toxicity can also be completely asymptomatic. Therefore, the role of radiologists is crucial in reporting early diagnosis to referring physicians. Drugs and patterns of drug-induced lung disease are catalogued in the international database “Pneumotox” (www. pneumotox.com). High-resolution computed tomography has the highest sensitivity for detecting infiltrative lung disease. Interstitial patterns include: nonspecific interstitial pneumonia, organising...

Early diagnosis of chemotherapy induced infiltrative lung disease is crucial for best patient management. High Resolution CT plays a key role in early diagnosis. Infections, pulmonary congestion and metastases are challenging differential diagnoses.

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