Bleomycin lung toxicity - organizing pneumonia pattern

Case contributed by Amr Farouk
Diagnosis almost certain

Presentation

Patient with metastatic breast cancer shifted to bleomycin chemotherapy 4 months ago.

Patient Data

Age: 60 years
Gender: Female

Initial CT exam of the chest before the start of bleomycin chemotherapy showed no pulmonary consolidations.

CT exam 3 months after showing newly developed multiple scattered bilateral pulmonary predominantly lower lobar areas of alveolar opacities (consolidations and ground glass infiltrates).

CT exam 3 months later showing newly developed multiple bilateral mainly upper lobar airspace alveolar opacities/consolidations with near total resolution of the lower lobar opacities.

Case Discussion

Bilateral multifocal ground glass opacifications and/or consolidation with a predominantly subpleural distribution in a patient receiving bleomycin representing interstitial lung disease (organizing pneumonia pattern).

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