CTICasesBleomycin-Induced Organizing Pneumonia
Imaging findings
High-resolution CT demonstrates patchy peripheral and subpleural consolidation, ground-glass opacities, and arcade-like perilobular opacities with subpleural sparing, classic for an organizing pneumonia pattern. A metastatic lesion from the patient's known testicular malignancy is also visible in the lung parenchyma. Follow-up imaging after the cessation of bleomycin and initiation of corticosteroid therapy demonstrates significant regression of the organizing pneumonia.
Key takeaways
Bleomycin is a chemotherapeutic agent well known for causing pulmonary toxicity, which frequently manifests as organizing pneumonia or nonspecific interstitial pneumonia. Recognizing the classic peripheral distribution and subpleural sparing of organizing pneumonia is key to differentiating drug-induced lung injury from infectious processes or malignant progression, allowing for prompt drug cessation and corticosteroid initiation.
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