Reversible bleomycin toxicity

Abstract

Pulmonary drug toxicity is an important cause of acute and chronic lung disease and is often under diagnosed. All forms of interstitial pneumonia have been reported to occur as a result of pulmonary drug toxicity with non specific interstitial pneumonia (NSIP) being the most common entity. Bleomycin is a chemotherapeutic agent used in the treatment of several tumours, including lymphoma, seminomatous and nonseminomatous germ cell tumours of the testes. Bleomycin-induced pulmonary toxicity occurs in 3–5% of treated patients and is the major factor that limits its dosage. Diffuse alveolar damage (DAD) is the most common manifestation of bleomycin-induced lung disease [1], with NSIP and bronchiolitis obliterans organizing pneumonia (BOOP) being less common. We report a case of reversible bleomycin induced pulmonary toxicity, in a patient of non-seminomatous germ cell tumour of testis, resembling usual interstitial pneumonia (UIP) on high resolution computed tomography (HRCT). Such an imaging feature of bleomycin induced pulmonary toxicity has not been described previously.