Seguchi M, Hirabayashi N, Fujii Y, Azuno Y, Fujita N, Takeda K, Sato Y, Nishimura M, Yamada K, Oka Y
Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Japan.
Transplantation. 2000 Jan 15;69(1):177-9. doi: 10.1097/00007890-200001150-00030.
Pulmonary vasculature abnormalities, including pulmonary veno-occlusive disease, have been demonstrated in marrow allograft recipients. However, it is often difficult to make a correct diagnosis of pulmonary lesions.
An open lung biopsy was performed on a patient who developed severe pulmonary hypertension after bone marrow transplantation for T-cell lymphoma.
An open lung biopsy specimen demonstrated pulmonary arterial occlusion due to intimal fibrosis and veno-occlusion. The most striking alteration was partial to complete occlusion of the small arteries by fibrous proliferation of the intima.
High-dose preparative chemotherapy and radiation before transplantation are thought to have contributed to the development of vasculopathy in this patient, because arterial occlusion by intimal fibrosis and atypical veno-occlusion are often associated with lung injury due to chemoradiation. An open lung biopsy is essential for diagnosing pulmonary vascular disease presenting signs compatible with posttransplantation pulmonary hypertension.
