Pulmonary fibrosis following low-dose 1,3-bis (2-chloroethyl)-1-nitrosourea (BCNU) therapy

Two women, 65 and 55 years old, with metastatic malignant melanoma, were treated with low doses of BCNU for a short period (six and three months, total dose 2500 and 2000 mg). Both patients developed pulmonary fibrosis, which was visible in postmortem examination. In the first woman, lesion development was so widespread as to be considered responsible for death. Because chest x-ray before treatment was not abnormal, we consider BCNU capable of inducing the lesion.