Bleomycin is an antineoplastic agent causing fatal pulmonary toxicity. Early 
diagnosis of bleomycin-induced pneumonitis is crucial to prevent irreversible 
damage. Pulmonary function tests are unreliable for identifying risk of 
bleomycin toxicity. Fluorodeoxyglucose PET/CT scanning can reveal inflammation 
secondary to pneumonitis but is not sufficiently specific for diagnosis. We 
retrospectively analyzed scans from 77 patients with Hodgkin lymphoma (median 
age 41 years, mean bleomycin dose 134 mg) to evaluate bleomycin-induced 
pneumonitis. We identified 13 patients with abnormal lung uptake of 
fluorodeoxyglucose. Tracer activity was predominantly diffuse, bilateral, in the 
lower lobes and subpleural areas. Interim scanning during treatment revealed 
pneumonitis in eight of 13 patients (asymptomatic in six). One asymptomatic 
patient died of bleomycin toxicity. For remaining 12 patients, bleomycin was 
discontinued and methylprednisolone given, all showed resolution of the 
pneumonitis. These findings suggest that routine interim or end-of-treatment 
FDG-PET/CT scanning could be beneficial for alerting clinicians to asymptomatic 
bleomycin-induced toxicity.