Premium
Nodular form of bleomycin‐related pulmonary injury in patients with osteogenic sarcoma
Author(s) -
Santrach Paula J.,
Askin Frederic B.,
Wells Robert J.,
Azizkhan Richard G.,
Merten David F.
Publication year - 1989
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19890815)64:4<806::aid-cncr2820640407>3.0.co;2-x
Subject(s) - medicine , bleomycin , pulmonary fibrosis , bronchiolitis obliterans organizing pneumonia , eosinophilic pneumonia , sarcoma , pathology , bronchiolitis obliterans , lesion , pulmonary injury , biopsy , pleurodesis , bronchiolitis , lung , pneumothorax , respiratory disease , fibrosis , radiology , chemotherapy , surgery , respiratory system , lung transplantation
Bleomycin (BLEO), an antitumor antibiotic effective against a variety of malignancies, has been associated classically with a pulmonary toxic reaction producing diffuse interstitial fibrosis. However, BLEO‐related pulmonary nodules have been reported recently, mostly in children and young adults treated for germ cell tumors. A different, apparent hypersensitivity reaction with prominent eosinophilic infiltrates has been seen in other patients. This report details the clinical history, radiographic features, and histopathologic condition of three patients with osteogenic sarcoma in whom pulmonary nodules developed during the course of their multiagent, BLEO‐containing chemotherapy. The predominant histopathologic lesion was bronchiolitis obliterans‐organizing pneumonia (BOOP); one patient had a significant eosinophilic infiltrate also. Pulmonary lesions developed in all of these patients after relatively low doses of BLEO ( < 200 mg). All of these patients underwent open lung biopsy to establish the diagnosis. Reported cases of BLEO‐induced pulmonary injury other than diffuse fibrosis are reviewed and comparisons are made with those in the current report. Also, suggestions are made for the management of these patients.