Pneumotox » Drug » Transhepatic arterial chemoembolization (TACE)

Transhepatic arterial chemoembolization (TACE)

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Fot 'Transhepatic Arterial Chemo-Embolization' (for the treatment of HCC (PMID 9599386, 24607940). See also under acrylate/methacrylate, lipiodol, and adriamycin/doxorubicin. Injected material may escape the lung and access the brain causing CNS complications. See under PMID 21036627, 27904836

Last update : 18/03/2018

I.b Pneumonitis (ILD)

2

I.c Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)

1

I.d Organizing pneumonia pattern (an area or areas of consolidation on imaging)

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I.e Acute eosinophilic pneumonia (AEP)

1

I.y Progression, acceleration or exacerbation of preexisting ILD/fibrosis

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I.z An area or areas of consolidation

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II.b ARDS - Acute lung injury

3

V.a Pleural effusion (uni- or bilateral) (can accompany DI-LDs)

1

VI.a Pulmonary embolism - Venous thrombosis/thromboembolism

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VI.e Fat/oil embolism - The FES embolism syndrome

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VI.v Foreign body/substance pulmonary embolism

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VI.aa Lipiodol pulmonary embolism

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XI.aa CNS symptoms or involvement, stroke

1

XV.c Path: Organizing pneumonia (OP/BOOP) pattern (see also Id)

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XVI.s Imaging: An area or areas of involvement with high attenuation numbers or metallic density

1

XVIII.h Eye-catcher: Lipiodol embolism

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Diagnosing DIRD

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Drug and radiation history

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Drug singularity - Correct identification of the drug

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Consistent timing of exposure v. onset of symptoms

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Clinical, imaging, BAL, pathological pattern consistent with the specific drug

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Careful exlusion of another cause

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Remission of symptoms with removal of drug

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Recurrence with rechallenge (rarely advisable)

8

Causality assessment

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