PMC9357382_01
Images of adjuvant radiotherapy treatment plan. (A) The monoisocentric technique with two anteroposterior and posteroanterior fields for the right supraclavicular area. (B) Two opposed tangential hemifields for the breast.
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Two opposed multi-leaf collimators (MLC)-customized fields of 6-10 MV photon beams on the supraclavicular area and two tangential MLC-customized fields with 6 MV photon beams on the breast were applied (Figure 1A and B).
CT images showing findings of radiation recall pneumonitis. (A) A crazy-paving pattern and thickening pulmonary interstitium on the apex of right lung. (B) Thickening of the right lung included in breast tangential fields and ground glass opacities (GGO) spread in both lungs.
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A crazy-paving pattern and thickened pulmonary interstitial tissue were observed, retracing the RT dose distribution of the treatment fields in the supraclavuclar area and the right lung behind the breast (Figure 2A and B).
Chest CT images after three months showing complete resolution with mild fibrosis. (A) Complete resolution in the supraclavicular area. (B) Same result in the right lung included in the tangential radiation fields; no opacities in both lungs.
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The chest CT scan performed three months later revealed a complete resolution of GGOs with residual pulmonary fibrosis within the irradiated fields. (Figure 3A and B).