Pulmonary Lymphangitis Poses a Major Challenge for Radiologists in an Oncological Setting during the COVID-19 Pandemic

Roberta Fusco; Igino Simonetti; Stefania Ianniello; Alberta Villanacci; Francesca Grassi; Federica Dell'Aversana; Roberta Grassi; Diletta Cozzi; Eleonora Bicci; Pierpaolo Palumbo; Alessandra Borgheresi; Andrea Giovagnoni; Vittorio Miele; Antonio Barile; Vincenza Granata

doi:10.3390/jpm12040624

Pulmonary Lymphangitis Poses a Major Challenge for Radiologists in an Oncological Setting during the COVID-19 Pandemic

J Pers Med. 2022 Apr 12;12(4):624. doi: 10.3390/jpm12040624.

Authors

Roberta Fusco¹, Igino Simonetti², Stefania Ianniello³, Alberta Villanacci³, Francesca Grassi⁴, Federica Dell'Aversana⁴, Roberta Grassi^{4

5}, Diletta Cozzi^{5

6}, Eleonora Bicci^{5

6}, Pierpaolo Palumbo⁷, Alessandra Borgheresi^{5

8}, Andrea Giovagnoni^{5

8}, Vittorio Miele^{5

6}, Antonio Barile⁹, Vincenza Granata²

Affiliations

¹ Medical Oncology Division, Igea SpA, 80013 Napoli, Italy.
² Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, 80131 Naples, Italy.
³ Diagnostica per Immagini nelle Malattie Infettive INMI Spallanzani IRCCS, 00161 Rome, Italy.
⁴ Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80127 Naples, Italy.
⁵ Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122 Milan, Italy.
⁶ Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy.
⁷ Abruzzo Health Unit 1, Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, 67100 L'Aquila, Italy.
⁸ Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy.
⁹ Department of Applied Clinical Science and Biotechnology, University of L'Aquila, Via Vetoio 1, 67100 L'Aquila, Italy.

Abstract

Due to the increasing number of COVID-19-infected and vaccinated individuals, radiologists continue to see patients with COVID-19 pneumonitis and recall pneumonitis, which could result in additional workups and false-positive results. Moreover, cancer patients undergoing immunotherapy may show therapy-related pneumonitis during imaging management. This is otherwise known as immune checkpoint inhibitor-related pneumonitis. Following on from this background, radiologists should seek to know their patients' COVID-19 infection and vaccination history. Knowing the imaging features related to COVID-19 infection and vaccination is critical to avoiding misleading results and alarmism in patients and clinicians.

Keywords: COVID 19; computed tomography; pulmonary lymphangitis; vaccination.