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Time to move out of the shadows: ILA in patients with lung cancer
  1. Jonathan A Rose,
  2. Gary M Hunninghake
  1. Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Gary M Hunninghake, Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; ghunninghake{at}

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Interstitial lung abnormalities (ILA) are incidentally identified abnormalities on chest computed tomography (CT) consistent with interstitial lung disease (ILD) in an individual without a known or suspected diagnosis. ILA have been associated with many adverse clinical outcomes including significant reductions in lung function,1 exercise capacity2 and survival,3 and in some cases may be a precursor for the most severe forms of ILD—idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis.4 ILA are becoming increasingly recognised in clinical practice, which motivated publication of a Fleischner Society Position Paper in 2020 to codify the definition for clinical use and begin to assemble suggestions for real-world management.5

Lung cancer and ILA are commonly coidentified on chest CT scans, given that both conditions can share some mutual risk factors.6 7 There have been several studies demonstrating an increased risk for adverse treatment-related consequences in patients with lung cancer with ILA including radiation pneumonitis,8 immune checkpoint inhibitor-induced pneumonitis,9 and mortality in general.7 Although adverse postoperative outcomes are well described …

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  • Contributors Critical revision of the manuscript for important intellectual content: both authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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