A 54-year-old woman with infiltrating ductal carcinoma of the right breast that had been treated with lumpectomy, locoregional radiation, and chemotherapy presented to the emergency department with a 4-week history of cough, fever, and dyspnea. On physical examination, an occasional cough was noted. Lung auscultation was normal. Computerized tomography (CT) of the chest is shown. What is the most likely diagnosis?
一位54岁女性，因右乳浸润性导管癌接受了乳房肿块切除术、局部区域放疗及化疗，现因持续4周的咳嗽、发热和呼吸困难至急诊就诊。体格检查发现偶有咳嗽，肺部听诊正常。胸部计算机断层扫描（CT）如图所示。最可能的诊断是什么？
A. Drug-induced pneumonitis药物性肺炎
B. Idiopathic pulmonary fibrosis特发性肺纤维化
C. Lymphangitis carcinomatosis癌性淋巴管炎
D. Radiation pneumonitis放射性肺炎
E. Viral pneumonia病毒性肺炎
答案解析：
胸部CT显示，右上叶放疗区域出现纤维化及磨玻璃样混浊影，伴局部肺容积缩小和小叶间裂上移，这些改变均与放疗野范围相符。最终诊断为放射性肺炎。放射性肺炎的发生风险随放疗剂量的增加而升高。该患者接受了糖皮质激素逐渐减量疗法进行治疗。
正确答案：D
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