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Nodular bleomycin toxicity.

M B Cohen1, J H Austin, A Smith-Vaniz

  • 1Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, New York 10032.

American Journal of Clinical Pathology
|July 1, 1989
PubMed
Summary
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Bleomycin lung toxicity typically causes diffuse lung changes. This case highlights an unusual presentation of bleomycin toxicity as pulmonary nodules, mimicking cancer metastasis, with associated bronchiolitis obliterans.

Area of Science:

  • Pulmonology
  • Oncology
  • Toxicology

Background:

  • Bleomycin is a chemotherapy agent known to cause pulmonary toxicity.
  • Pulmonary interstitial fibrosis is a common manifestation of bleomycin-induced lung injury.
  • Radiographic findings usually include diffuse reticular patterns.

Purpose of the Study:

  • To report an unusual case of bleomycin toxicity.
  • To describe a presentation mimicking metastatic cancer.
  • To highlight distinct histologic findings.

Main Methods:

  • Case report of a patient undergoing bleomycin therapy.
  • Review of radiographic findings.
  • Histopathologic examination of lung biopsy specimens.

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Main Results:

  • Biopsy-proven bleomycin toxicity presented as pulmonary nodules.
  • The presentation mimicked metastatic malignancy.
  • Histology showed features of diffuse toxicity and bronchiolitis obliterans.

Conclusions:

  • Bleomycin toxicity can manifest atypically as pulmonary nodules.
  • This presentation can be mistaken for metastatic disease.
  • Bronchiolitis obliterans may be a feature of this unusual toxicity pattern.