Other Drugs
Roberto Barrios
Alvaro C. Laga
Mary L. Ostrowski
Carlos Bedrossian
Hakan Çermik
Other drugs that may induce pulmonary toxicity include cyclophosphamide, bleomycin, busulphan, sulfasalazine, and nitrofurantoin. Cyclophosphamide pulmonary toxicity is more common in combination chemotherapy regiments. According to various reports, the incidence of busulphan pulmonary toxicity in patients treated with this chemotherapeutic agent ranges widely. Nitrofurantoin is a drug with multiple pulmonary manifestations; toxicity is generally acute in onset, with presentation occurring within a few weeks of initiating the therapy.
Cytologic Features
Cellular atypia including large and hyperchromatic nuclei with coarse granular or smudged chromatin.
Intranuclear vacuoles, binucleation, or multinucleation are frequently seen.
Histologic Features
Cyclophosphamide
Interstitial pneumonia.
May present as diffuse alveolar damage or organizing pneumonia.
Bleomycin
Intracellular edema and blebbing of endothelial cells.
Necrosis of type 1 pneumocytes, loss of lamellar inclusions in type 2 pneumocytes, and pneumocyte atypia.
Fibroblast proliferation and fibrosis.