ABSTRACT
A 69-year-old man developed dyspnea and cough with diffuse crackles on chest examination approximately eight months after starting bicalutamide therapy (200 mg daily) for prostate cancer. A chest X-ray revealed diffuse reticulonodular infiltrates bilaterally, predominantly in the bases. Pulmonary function tests showed a moderate restrictive pattern. Bronchoscopy and lung biopsy ruled out infectious or neoplastic causes but showed a diffuse interstitial thickening with mild fibrosis, eosinophilia, histiocytes and giant cells with reactive alveolar pneumocytes. Diagnosis was interstitial pneumonitis with eosinophilia and granulomatosis. Bicalutamide was discontinued and therapy with corticosteroids resulted in symptom improvement. Within four months the chest X-ray was normal.
