[Cytostatic pneumonitis in children. Pathogenetic and morphologic aspects]

Pulmonary complications of cytostatic treatment have been reported with increasing frequency in children treated for leukaemia. A report is given of the morphology of biopsy specimens of children receiving combined cytostatic treatment complicated by fatal pneumonitis. Histology showed fibrosing interstitial changes with variable phases of proliferation. In addition, unusual proliferation of epithelium and massive increase and activation of the monocyte-macrophage system were observed. Histochemical analysis permitted histogenetic classification of proliferating, and in part atypical, cell forms. Knowledge of the relevant clinical data is essential otherwise the findings cannot be differentiated with certainty from paraneoplastic epithelial anomalies or atypical cells induced by virus infection. The prognosis of cytostatic pneumonitis decisively depends on early correct diagnosis. Complete restitution without typical pulmonary fibrosis can be expected only under ideal conditions, i.e. timely exclusion of the detrimental cytostatics.