Late BCNU lung: a light and ultrastructural study on the delayed effect of BCNU on the lung parenchyma.
AuthorsHasleton, Philip S
O'Driscoll, B R
Kalra, S J
Woodcock, A A
Poulter, L W
AffiliationDepartment of Pathology, Wythenshawe Hospital, Manchester, U.K.
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AbstractWe describe eight patients who developed interstitial pulmonary fibrosis following BCNU (carmustine) therapy for cerebral tumours. The fibrosis presented 12-17 (mean 14) years after exposure to the drug. A distinctive pattern of pulmonary fibrosis with involvement of the apices and subpleural areas was seen in one patient dying of the disease. Light microscopy showed interstitial elastosis and intra-alveolar fibrosis which was often focal with an associated mild lymphoplasmacytic infiltrate, intra-alveolar oedema, macrophages, and some neutrophils. Ultrastructural studies showed electron lucency of type I pneumocytes, with breaks in the cytoplasmic membranes leaving a bare basement membrane. Degenerative change was also seen in endothelial cell cytoplasm along with lipofuscin deposition. While BCNU pulmonary fibrosis has been described up to 2 years after treatment, this complication so late after therapy, though rare, has important implications for the follow-up of patients receiving this drug.
CitationLate BCNU lung: a light and ultrastructural study on the delayed effect of BCNU on the lung parenchyma. 1991, 164 (1):31-6 J. Pathol.
JournalThe Journal of Pathology