RADIOLOGIC CONFERENCE

Gene Margaret Bernabe

Internal Medicine

Pulmonary Function Test

Mild restrictive ventilatory defect
with no significant response to
bronchodilator.
There is mild impairment in gas
exchange.

Bleomycin
chemotherapeutic agent commonly
used to treat curable diseases such
as germinative tumors and Hodgkins
lymphoma
AE: pulmonary toxicity

Bleomycin
bronchiolitis
eosinophilic
interstitial

Chest radiographic Findings

bilateral, bibasilar
infiltrates

High-resolution computed
tomography (HRCT)
more sensitive
Diffuse alveolar
damage is
associated with
airspace
consolidation and
ground-glass
opacities.

 Endstage fibrosis
extensive reticular
markings,
Traction bronchiectasis,
and honeycombing

Brochiolitis
Obliterans
Organizing
pneumonia
manifests as groundglass opacities in a
bilateral but asymmetric
pattern or by airspace
consolidation with a
subpleural or
peribronchial
distribution.

Pulmonary Function Test

Reduced carbonmonoxide diffusion
capacity
Restrictive ventilator defect

 Patients receiving Bleomycincontaining regimens, age over 40

years was associated with a 2.3-fold
higher risk of pulmonary
complications
stage IV disease at presentation (HR
2.6)
cumulative dose of >300000 IU (HR
J.M.OSullivan, R. A. Huddart,A. R.Norman, J.
3.5)
Nicholls,D. P.
Dearnaley, and A. Horwich, Predicting the risk of
bleomycin
lung toxicity in patients with germ-cell tumours,
Annals of
Oncology, vol. 14, no. 1, pp. 9196, 2003.

 Cumulative doses of >400U are also

associated with higher rates of
pulmonary toxicity

H. S. Haugnes, N. Aass, S. D. Fossa et al.,

Pulmonary function in long-term survivors of
testicular cancer, Journal of Clinical Oncology,
vol. 27, no. 17, pp. 27792786, 2009.

Treatment
Prednisone at 0.75 - 1mg/kg
After 4-8 weeks - tapered over an
additional
4-6 months in accordance with the
patients condition and clinical
response

THANK YOU!