
Figure 9a. Radiation pneumonitis in a 60-year-old man with recurrent lung cancer following left lower lobectomy. The unusual location of the disease reflects the use of oblique portals. (a) Localization radiograph shows a right anterior oblique mediastinal portal. A radiation dose of 24 Gy was administered with right anterior and left posterior oblique beam angles after irradiation with 30 Gy in an anteroposterior-posteroanterior direction. (b) Radiograph obtained 4 weeks after completion of radiation therapy shows ill-defined haziness in the upper and middle left lung. (c, d) CT scans obtained through the aortic arch (c) and at the subcarina level (d) at the same time as b demonstrate asymmetric, patchy consolidation anterolaterally in the right lung and posterolaterally in the left lung conforming to the shape of the right anterior and left posterior oblique portals.