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

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 28 February 2017, last major update September 2011

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed search: amiodarone pulmonary toxicity

Cite this page: Amiodarone induced pulmonary toxicity. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lungnontumoramiodarone.html. Accessed April 25th, 2017.
Definition / General
  • 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
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 nonspecific interstitial pneumonia or desquamative interstitial pneumonia
Micro Images

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Various images

Cytology Description
  • Finely vacuolated, foamy macrophages; variable neutrophils
Electron Microscopy 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