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Bleomycin-induced pulmonary toxicity with cavitation and pneumothorax

Imaging findings

CT scan of a patient with testicular cancer receiving bleomycin demonstrates subpleural consolidation consistent with organizing pneumonia, along with cavitary pulmonary lesions containing air-fluid levels and a small spontaneous pneumothorax.

Key takeaways

Bleomycin-induced lung toxicity classically presents as organizing pneumonia or interstitial fibrosis. Cavitation and pneumothorax are rare manifestations of bleomycin toxicity, and other etiologies like necrotic metastases or septic emboli must be ruled out.

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