Cytotoxic agents may cause interstitial or eosinophilic pneumonitis, alveolar 
proteinosis, pulmonary venous occlusive disease, pulmonary fibrosis, 
pneumothorax, or pulmonary oedema. These agents may also potentiate lung injury 
caused by radiotherapy or high oxygen fractions in inspired air. Clinical and 
roentgenological features of lung damage induced by cytotoxic drugs are usually 
non-specific, and differential diagnoses include progression of the malignant 
disease and a plethora of opportunistic infections. Monitoring of blood gases 
and carbon monoxide transfer factor may facilitate early detection of drug 
induced lung injury. Fiberoptic bronchoscopy, bronchoalveolar lavage, 
transbronchial biopsy, or open lung biopsy may be necessary for reliable 
diagnosis. Early detection of lung damage and immediate withdrawal of the 
responsible agent(s) are essential. Steroids may be of therapeutic value in some 
patients.