A 60-year-old woman on long-term medication presents with progressive dyspnoea and dry cough. HRCT shows peripheral, basal-predominant ground-glass and reticular opacities. Which drug is most commonly associated with this pattern of pulmonary toxicity?

• A Amiodarone
• B Nitrofurantoin
• C Bleomycin
• D Methotrexate ✓

Explanation

Methotrexate commonly causes hypersensitivity pneumonitis-like pattern with bilateral ground-glass and reticular opacities in a basal-predominant distribution. Amiodarone toxicity shows high-attenuation liver and diffuse interstitial changes. Bleomycin causes basal reticulonodular opacities. Nitrofurantoin causes acute bilateral infiltrates or chronic fibrosis.

Reference: Webb, Müller, and Naidich: High-Resolution CT of the Lung, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.