Drug Toxicities

Busulfan toxicity

The pattern is a non-specific interstitial pneumonia with scattered large atypical epithelial cells, which are shown below.

Busulfan toxicity

Busulfan produces marked atypia of type II cells in the lung and glandular cells of other organs. Nuclei are hyperchromatic, and the N/C ratio is increased. Compare the size of the atypical cells (arrows) with adjacent type II cells. These cells should not be mistaken for CMV-infected cells, which have nuclear and cytoplasmic inclusions.

Cyclophosphamide toxicity

Cyclophosphamide toxicity shows a non-specific interstitial pneumonia with type II cell atypia, but less so than with busulfan.