Bleomycin-induced nodular pulmonary fibrosis masquerading as metastatic testicular cancer

Bleomycin has become an important component of combination chemotherapy, particularly in the treatment of metastatic testis carcinoma. Pulmonary toxicity is a major risk and irreversible pulmonary fibrosis or even death may result from its use. Rarely diffuse fibrosis may lead to discrete nodularity mimicking pulmonary metastasis. We report such a case, and discuss the various clinical, radiographic and histopathological forms of bleomycin-induced pulmonary toxicity.