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

Research Paper

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

Qi Zeng1,2, Caihua Tang1,3, Lisi Deng1,4, Sheng Li5, Jiani Liu1,2, Siyang Wang1,2✉, Hong Shan1,3✉

1. Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province, China, 519000.
2. Cancer Center,The Fifth Affiliated Hospital, Sun Yat-Sen University, No. 52 Meihua East Road, Zhuhai, Guangdong Province, China, 519000;
3. Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-Sen University, No. 52 Meihua East Road, Zhuhai, Guangdong Province, China, 519000;
4. Department of infectious disease, The Fifth Affiliated Hospital, Sun Yat-Sen University, No. 52 Meihua East Road, Zhuhai, Guangdong Province, China, 519000;
5. Department of Radiology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng East Road, Guangzhou, Guangdong Province, China, 50060.

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Citation:
Zeng Q, Tang C, Deng L, Li S, Liu J, Wang S, Shan H. Differential Diagnosis of COVID-19 Pneumonia in Cancer Patients Received Radiotherapy. Int J Med Sci 2020; 17(16):2561-2569. doi:10.7150/ijms.46133. Available from http://www.medsci.org/v17p2561.htm

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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, Pneumonia, Radiation pneumonitis, Multidetector computed tomography.