title: FELD better not thinking of metastases only when liver lesions appear after bleomycin-based treatment for non-seminoma testis from metastases.
abstract: BACKGROUND
  Bleomycin has become an integral part of chemotherapy in patients with germ-cell tumors. One of the most feared side effects is bleomycin-induced pneumonitis. In patients with mild or moderate BIP, radiological signs disappear almost completely within nine months after discontinuation of bleomycin treatment.
  
  
  METHODS
  We present a patient with a history of non seminoma of the testis and bleomycin-induced pneumonitis. During follow-up, regression of the hypothesis of eosinophilic migration to the liver after regression of bleomycin-induced pneumonitis is highly suspicious based on transient eosinophilia and focal eosinophilic liver disease.
  
  
  CONCLUSIONS
  As follow up may consist of CT scanning in germ-line tumor patients, transient eosinophilic liver lesions reported during regressive bleomycin-induced pneumonitis should not be presumed automatically as metastatic tumor relapse and require further sequential imaging and pathological examination.
authors.affiliation: Department of Medical Oncology, Radboud University Nijmegen Medical Centre, P,O, Box 9101, 6500 HB Nijmegen, Netherlands. f.devos@umcutrecht.nl.
authors.forename: Filip Y F L
authors.initials: FY
authors.lastname: De Vos
authors.forename: Sasja F
authors.initials: SF
authors.lastname: Mulder
authors.forename: Joost P H
authors.initials: JP
authors.lastname: Drenth
authors.forename: Iris D
authors.initials: ID
authors.lastname: Nagtegaal
authors.forename: Jurgen J
authors.initials: JJ
authors.lastname: Fütterer
authors.forename: Winette T A
authors.initials: WT
authors.lastname: van der Graaf
mesh_terms: D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D001761:Bleomycin / Q000009:adverse effects* / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000473:pathology*; D004802:Eosinophilia / Q000139:chemically induced; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009367:Neoplasm Staging; D013736:Testicular Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin