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Case Reports
. 2021 Mar 4;13(3):e13688.
doi: 10.7759/cureus.13688.

A Case of Suspected Radiation Recall Pneumonitis After a COVID-19 Infection

Hiromasa Kurosaki  1 , Nobuko Utsumi  1 , Kosei Miura  1   2
Affiliations
Case Reports

A Case of Suspected Radiation Recall Pneumonitis After a COVID-19 Infection

Hiromasa Kurosaki et al. Cureus. .

Abstract

We present the case of a 78-year-old woman who received definitive radiation therapy for small cell lung cancer three and a half years ago. She was asymptomatic when she tested positive for coronavirus disease 2019 (COVID-19). She then developed a rapid decline in respiratory status on day seven. Chest radiograph revealed a strong shadow at the prior irradiation site. Radiation recall reactions are usually caused by drug administration, but in this case, it was suspected to be caused by COVID-19.

Keywords: covid-19; lung cancer; radiation recall reaction; radiotherapy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Portal images for small cell lung cancer. (A) 30 Gy/20 fractions; (B) 15 Gy/10 fractions.
Figure 2
Figure 2. X-p image. (A) X-p five months after curative radiation therapy: radiation pneumonia consistent with the irradiation field was observed. (B) X-p 3.5 years after the curative radiation therapy. This is two weeks before SARS-CoV-2 positivity: radiation-induced pulmonary fibrosis was observed. (C) X-p one day prior to SARS-CoV-2 positivity: no change from two weeks prior. (D) X-p on the day of rapid deterioration of respiratory condition observation (day seven): appearance of ground-glass shadow showing dilated bronchi inside. (E) X-p two days later: a shadow consistent with the irradiation was observed (day nine). (F) X-p 46 days after SARS-CoV-2 positivity.
X-p, chest radiograph; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
Figure 3
Figure 3. CT image 1.5 months prior to COVID-19 infection. The red arrow shows radiation fibrosis and the blue arrow shows interlobar fissure.
CT, computed tomography; COVID-19, coronavirus disease 2019
See this image and copyright information in PMC

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