الفهرس 
Introduction
PathologyOnly 14 pages are availabe for public view
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Abstract
This study was carried out to identify the main radiological findings of early and late RILD, and to differentiate radiationinduced lung damage from infection, local recurrence, or metastasis. The study was conducted in Radiology Department of Mansoura University Hospital on 34 patients. Their age ranged from 29 to 72 years (mean = 48.8 years). These patients were 28 females and 6 males. All patients were referred from Clinical Oncology and Nuclear Medicine Department. They all had different types of thoracic and chest wall malignancies for which they received radiotherapy. Plain xray chest PA view, post contrast spiral CT, and highresolution CT of the chest were done for all patients. 11 patients were imaged within 6 months of the last day of radiation therapy, and 23 patients were imaged after <U+2265> 6 months. Follow up CT scans were done in 3 patients. Tuberculin test was done for 2 patients, and aspiration cytology from pleural effusion was done in one patient. from this study we concluded that RILD is a common finding after radiation therapy to the lung. Radiological findings of early RILD include groundglass opacities, consolidation with air bronchogram, and pleural effusion rarely occurs. Radiological findings of late RILD include fibrosis with traction bronchiectasis, groundglass opacities, consolidation, pleural thickening, and pleural effusion. BOOPtype pneumonia can occur after radiation therapy to the lung. Radiological findings include bilateral patchy areas of consolidation with airfilled spaces; pleural thickening and pleural effusion may also be present. The finding that cases can be presented by both RILD as well as metastasis leads to the conclusion that the presence of RILD does not exclude the possibility of Metastatic process. Post contrast spiral CT has been widely used in patients treated from different types of thoracic and chest wall malignancies for follow up of disease as well as post treatment complications. In this study both post contrast and HRCT scans were able to diagnose almost all cases. However, post contrast CT detected lung nodules better, while HRCT was better in detection of groundglass opacities. The use of HRCT with thin collimation improves visualization of small parenchymal structures and characterization of disease process. Among the predominant patterns of lung infiltration in radiationinduced lung injury, groundglass opacity is one of the most difficult to diagnose and is particularly influenced by the CT technique. The importance of groundglass opacities in postradiation changes is due to the fact that it may be the only radiological finding of lung injury which may pass unnoticed leading to permanent lung damage and fibrosis. HRCT can be used in the follow up of patients with chest wall and thoracic malignancies, with the benefit of low radiation dose as well as avoiding the hazards of contrast media. However, contrast administration may be needed especially in cases where metastatic process is suspected. There are some cases where further investigations including laboratory tests or even biopsy are needed to exclude metastasis.