Differential Diagnosis of COVID-19 Pneumonia in Cancer Patients Received Radiotherapy

Int J Med Sci. 2020 Sep 16;17(16):2561-2569. doi: 10.7150/ijms.46133. eCollection 2020.

Abstract

Background: During the outbreak period of COVID-19 pneumonia, cancer patients have been neglected and in greater danger. Furthermore, the differential diagnosis between COVID-19 pneumonia and radiation pneumonitis in cancer patients remains a challenge. This study determined their clinical presentations and radiological features in order to early diagnose and separate COVID-19 pneumonia from radiation pneumonitis patients promptly. Methods and Findings: From January 21, 2020 to February 18, 2020, 112 patients diagnosed with suspected COVID-19 were selected consecutively. A retrospective analysis including all patients' presenting was performed. Four patients from 112 suspected individals were selected, including 2 males and 2 females with a median age of 54 years (range 39-64 years). After repeated pharyngeal swab nucleic acid tests, 1 case was confirmed and 3 cases were excluded from COVID-19 pneumonia. Despite the comparable morphologic characteristics of lung CT imaging, the location, extent, and distribution of lung lesions between COVID-19 pneumonia and radiation pneumonitis differed significantly. Conclusions: Lung CT imaging combined with clinical and laboratory findings can facilitate early diagnosis and appropriate management of COVID-19 pneumonia with a history of malignancy and radiation therapy.

Keywords: COVID-19; Multidetector computed tomography.; Pneumonia; Radiation pneumonitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Betacoronavirus*
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / diagnostic imaging*
  • Diagnosis, Differential*
  • Esophageal Neoplasms / diagnostic imaging
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / radiotherapy
  • Female
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / radiotherapy
  • Male
  • Middle Aged
  • Nasopharyngeal Neoplasms / diagnostic imaging
  • Nasopharyngeal Neoplasms / pathology
  • Nasopharyngeal Neoplasms / radiotherapy
  • Neoplasms / radiotherapy*
  • Neoplasms / virology
  • Pandemics
  • Pneumonia, Viral / diagnostic imaging*
  • Radiation Pneumonitis / diagnostic imaging*
  • Retrospective Studies
  • SARS-CoV-2
  • Tomography, X-Ray Computed