Pulmonary changes at computed tomography in patients with testicular carcinoma treated with cis-platinum, vinblastine...

Computed tomography was performed before and after CVB therapy (cis-platinum, vinblastine, bleomycin) in 42 patients with metastatic testicular carcinoma. Twenty-one of these (3 symptomatic, 18 asymptomatic) developed subpleural pulmonary abnormalities which were streaky or reticular in 7, homogeneous with a broad base against pleura in 3 and had a mixed pattern in 11 patients. Histologic examination was obtained in 3 patients and showed fibrosis with no tumor tissue. Twelve patients with marked CVB induced abnormalities underwent repeat CT within 6 to 24 weeks. Changes disappeared spontaneously in 7, diminished in 3 and increased in 2 of these. Further conventional chest radiography of the latter two revealed complete regression of changes. Pulmonary lesions induced by CVB therapy should be kept in mind at follow-up so that an erroneous diagnosis of tumor progression is not made.