Lung - nontumor - Amiodarone induced pulmonary toxicity

Home Chapter Home Jobs Conferences Fellowships Books

Lung-nontumor

Other interstitial pneumonitis / fibrosis

Amiodarone induced pulmonary toxicity

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 24 September 2011, last major update September 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
=========================================================================

● Oral antiarrythmic drug, usually used long term
● 5-10% of patients develop lung injury
● Risk factors are: advanced age, higher dose therapy, lung surgery, oxygen therapy and underlying pulmonary disease; disease may occur without risk factors or at lower doses
● Drug inhibits phospholipid degradation by lysosomes, resulting in phospholipid accumulation within cells, especially alveolar macrophages

Case reports
=========================================================================

● 68 year old man with amiodarone induced pulmonary toxicity (Arch Pathol Lab Med 2002;126:745)

Treatment
=========================================================================

● Drug withdrawal or dose reduction, corticosteroid therapy
● May have 50% mortality if diffuse alveolar damage is present

Micro description
=========================================================================

● Intra-alveolar exudate of finely vacuolated foamy macrophages, also present within alveolar septa
● May have diffuse alveolar damage, cryptogenic organizing pneumonia type changes or changes of non-specific interstitial pneumonia or desquamative interstitial pneumonia

Micro images
=========================================================================

Various images

Cytology description
=========================================================================

● Finely vacuolated, foamy macrophages; variable neutrophils

EM description
=========================================================================

● Membrane-bound cytoplasmic lamellar inclusions due to drug accumulation in the lungs
● Morphologic findings are not specific and must be interpreted in conjunction with the clinical history

End of Lung-nontumor > Other interstitial pneumonitis / fibrosis > Amiodarone induced pulmonary toxicity

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).