Medical Central Resource
Acute Bleomycin Toxicity
Nusser, Christopher
11/27/96
Presentation
32 year old male with increasing shortness of breath.
Imaging Technique
Plain X-ray
Imaging Findings
Acute (normal one month prior) interstial process, linear pattern, also could consider reticular nodular pattern more pronounced in the lower lobes.
Diagnosis
Acute Bleomycin Toxicity
Discussion
Chemotherapeutic agents: Bleomycin:
Bleomycin is the chemotherapeutic agent most commonly
associated with pulmonary toxicity. Doses in excess of 400 mg are associated
with an increased risk for pulmonary toxicity . Lung damage is potentiated by concurrent radiation therapy or oxygen administration. The lung disease is usually chronic and leads to bibasilar reticular opacities that may progress to air space consolidation. Peripheral linear and nodular opacities, predominantly in the lung bases, are the earliest findings in bleomycin toxicity. The presence of multiple pulmonary nodules has also been reported with bleomycin toxicity and can mimic metastatic disease. Rarely, patients may experience an anaphylactic response to the agent which can lead to pulmonary edema.
Submitted by: Christopher Nusser,Capt,USAF,MC,Wilford Hall Medical Center
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