Late BCNU lung: A light and ultrastructural study on the delayed effect of BCNU on the lung parenchyma

Research output: Contribution to journalArticle

  • Authors:
  • P. S. Hasleton
  • B. R. O'Driscoll
  • P. Lynch
  • A. Webster
  • S. J. Kalra
  • And 3 others
  • External authors:
  • H. R. Gattamaneini
  • A. A. Woodcock
  • L. W. Poulter


We 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.

Bibliographical metadata

Original languageEnglish
Pages (from-to)31-36
Number of pages5
JournalJournal of Pathology
Issue number1
Publication statusPublished - 1991