rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2015-0-3-46-51rentrad-69Research ArticleСЛУЧАЙ ИЗ ПРАКТИКИCLINICAL NOTEЛегочная цитотоксичность, индуцированная приемом блеомицина и метотрексатаPulmonary cytotoxicity induced by bleomycin and methotrexateШейхЖ. В.SheykhZh, V,

д. м. н., заведующая отделением компьютерной томографии

MD, PhD, DSc, Chief of Computed Tomography Department

КруцкевичА. О.KrutskevichA. O.

ординатор

Resident Physician

ДребушевскийН. С.DrebushevskiyN. S.

к. м. н., заведующий отделением лучевой и радиоизотопной диагностики

MD, PhD, Chief of Department of Radiation and Radioisotope Diagnosis

ШвайкоС. Н.ShvaykoS. N.

к. м. н., заведующая отделением пульмонологии

MD, PhD, Chief of Departmet of Pulmonology

ДунаевА. П.DunaevA. P.

к. м. н., врач-рентгенолог отделения лучевой и радиоизотопной диагностики

MD, PhD, Radiologist of Department of Radiation and Radioisotope Diagnosis

АлексеевВ. Г.AlekseevV. G.

д. м. н., профессор, заместитель главного врача по терапии

MD, PhD, DSc, Professor, Deputy Physician-in-Chief for Therapy

ГБУЗ «Городская клиническая больница им. С.П. Боткина» Департамента здравоохранения г. МосквыРоссияS.P. Botkin City Clinical Hospital, Moscow City Health DepartmentRussian FederationФГБУ ГНЦ «Федеральный медицинский биофизический центр им. А.И. Бурназяна» ФМБА РоссииРоссияA.I. Burnazyan Federal Medical Biophysical Center, Federal Medical-Biological Agency of RussiaRussian Federation201503032016034651Copyright © Шейх Ж.В., Круцкевич А.О., Дребушевский Н.С., Швайко С.Н., Дунаев А.П., Алексеев В.Г., 20162016Шейх Ж.В., Круцкевич А.О., Дребушевский Н.С., Швайко С.Н., Дунаев А.П., Алексеев В.Г.Sheykh Z.V., Krutskevich A.O., Drebushevskiy N.S., Shvayko S.N., Dunaev A.P., Alekseev V.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/69

Раннее выявление лекарственно-индуцированных поражений паренхимы легких часто бывает затруднено ввиду неспецифических клинико-рентгенологических проявлений. Обычно диагноз основывается на истории приема препарата, клинико-рентгенологической картине и исключении других причин поражения легочной ткани.

Чаще всего патологические изменения со стороны легких вызывают химиопрепараты. В целом приблизительно у 10% всех пациентов, получающих химиотерапию, развиваются патологи ческие изменения легочной паренхимы. Основными химиопрепаратами, вызывающими поражение легких, являются блеомицин, метотрексат, кармустин, бусульфан и циклофосфомид.

Из всех методов обследования компьютерная томография является самым чувствительным методом определения лекарственно-индуцированной патологии легочной паренхимы, собенностей распределения и динамики ее развития.

Приведены данные литературы и 2 клинических наблюдения поражения легких, индуцированного приемом блеомицина и метотрексата.

 

Early detection of drug-induced pulmonary parenchymal injuries is often hampered by nonspecific clinical and X-ray manifestations. The diagnosis is usually based on a history of drug use, clinical and X-ray presentation, and exclusion of other causes of lung tissue injury.Chemical preparations most commonly cause pathological pulmonary changes. Overall, about 10% of all patients receiving chemotherapy develop pathological changes in the lung parenchyma. The main chemical preparations causing lung injury are bleomycin, methotrexate, carmustine, busulfan, and cyclophosphamide.

Out of all examination techniques, computed tomography is most sensitive in determining the presence, specific features, and trends in the development of drug-induced pulmonary parenchymaldisease.The paper gives the data available in the literature and 2 clinical observations of  pulmonary parenchymal disease induced by bleomycin and methotrexate.

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The authors declare that there are no conflicts of interest present.