Recall of radiation pneumonitis after intrapleural administration of doxorubicin.

A 67-year-old woman developed a malignant pleural effusion 18 months after radical mastectomy and radiotherapy for carcinoma of the breast. After drainage, 30 mg of doxorubicin was instilled into the pleural cavity. Thirty-six hours later, she developed fever, dyspnoea, and erythema in the area of the previous radiotherapy field; patchy intrapulmonary opacities were evident on chest X-ray film. These features resolved over two weeks after treatment with prednisone and frusemide. We believe that this represents a radiation-recall phenomenon.