Franquet Tomás, Müller Nestor L, Lee Kyung S, Oikonomou Anastasia, Flint Julia D
Department of Radiology, Vancouver Hospital and Health Sciences Centre and University of British Columbia, 855 W 12th Ave, Vancouver, BC, Canada V5Z 1M9.
Radiology. 2005 Jul;236(1):332-7. doi: 10.1148/radiol.2361031772. Epub 2005 Jun 13.
To retrospectively evaluate thin-section computed tomographic (CT) findings in hematopoietic stem cell transplant (ie, bone marrow transplant) patients with histopathologically proved pulmonary candidiasis.
Ethical approval was obtained from the institutional review board of each of the three institutions; informed consent was not required. The study included 17 hematopoietic stem cell transplant recipients with proved pulmonary candidiasis. Histopathologic specimens were acquired at transbronchial biopsy (n = 8), open lung biopsy (n = 6), and autopsy (n = 3). The patients included seven men and 10 women (age range, 20-62 years; mean age, 37 years). The thin-section CT scans were retrospectively reviewed by two thoracic radiologists for the presence, appearance, and distribution of parenchymal abnormalities.
Multiple nodules were present in 15 (88%) patients, including centrilobular nodules and tree-in-bud pattern in seven (41%) patients. Nodules were bilateral in 12 patients and unilateral in three. An associated halo of ground-glass opacity was identified in five (33%) patients. Nodules were the only CT finding in five patients (29%). Areas of air-space consolidation were identified in 11 (65%) patients. Areas of ground-glass opacity were seen in six (35%) of 17 patients and were always associated with other abnormalities. Other less common CT findings included pleural effusion (n = 3), thickening of the bronchial walls (n = 2), and cavitation (n = 1).
The most common thin-section CT findings of pulmonary candidiasis in hematopoietic stem cell transplant patients are multiple bilateral nodular opacities often associated with areas of consolidation.
回顾性评估经组织病理学证实患有肺念珠菌病的造血干细胞移植（即骨髓移植）患者的薄层计算机断层扫描（CT）表现。
获得了三个机构各自的机构审查委员会的伦理批准；无需知情同意。该研究纳入了17例经证实患有肺念珠菌病的造血干细胞移植受者。通过经支气管活检（n = 8）、开胸肺活检（n = 6）和尸检（n = 3）获取组织病理学标本。患者包括7名男性和10名女性（年龄范围20 - 62岁；平均年龄37岁）。两名胸部放射科医生对薄层CT扫描进行回顾，以观察实质异常的存在、表现和分布。
15例（88%）患者出现多发结节，其中7例（41%）患者有小叶中心结节和树芽征。12例患者结节为双侧性，3例为单侧性。5例（33%）患者可见相关的磨玻璃样晕环。5例患者（29%）结节是唯一的CT表现。11例（65%）患者发现气腔实变区域。17例患者中有6例（35%）出现磨玻璃样密度影，且总是与其他异常相关。其他不太常见的CT表现包括胸腔积液（n = 3）、支气管壁增厚（n = 2）和空洞形成（n = 1）。
造血干细胞移植患者肺念珠菌病最常见的薄层CT表现是多发双侧结节状实变影，常伴有实变区域。
