Are there overlapping clinical features between thoracic radiotherapy side effects and covid-19 pneumonia? radiation pneumonitis outside the radiation ports : three case reports

Lazzari, Grazia; Chiara Resta, Elda; Magli, Michelle; D'Ettorre, Ernesto; Silvano, Giovanni

Respiratory involvement of Covid-19 infection, presenting as a mild flu-like illness to potentially lethal acute respiratory distress syndrome is the main clinical manifestation in adults. Chest imaging shows a pictorial fashion of images due to the severity and stage of the disease, starting from focal nodular or mass-like opacities with air bronchogram to areas of ground glass consolidation or whited out lung. However, at the Covid-19 pandemic time, CT findings could yield confounding reporting in case of cancer patients previously treated with thoracic radiotherapy (tRT) due to atypical radiation pneumonitis occurring outside the radiation ports. Hypersensitivity pneumonitis and radiation induced bronchiolitis obliterans organizing pneumonitis (RT-BOOP) are accounted in this report.