Feuillet S, Meignin V, Brière J, Brice P, Rocha V, Socié G, Tazi A, Bergeron A
Université Denis Diderot-Paris 7, Assistance Publique-Hôpitaux de Paris, Service de Pneumologie, Hôpital Saint-Louis, Paris, France.
Clin Med Case Rep. 2009 Feb 3;2:11-5. doi: 10.4137/ccrep.s2084. eCollection 2009.
The Epstein-Barr virus (EBV) associated Post-Transplant Lymphoproliferative Disorders (PTLD) are increasingly recognized as a fatal complication of hematological stem cell transplantation (HSCT). Thoracic involvement, that may be isolated or part of a disseminated disease, usually encompasses pulmonary nodules or masses and mediastinal lymph node enlargement. The current case study presents 2 patients who underwent HSCT, one allogenic and the other autologous, who developed an exceptional endobronchial EBV related PTLD. The first patient had a fleshy white endobronchial mass resulting in a right upper lobe atelectasis and the second had an extensive necrotising mucosa from trachea to both basal bronchi without any significant change of lung parenchyma on the CT scan. In both cases, the diagnosis was made by bronchial biopsies. Physicians should be aware of an endobronchial pattern of EBV associated PTLD after HSCT to permit quick diagnosis and therapeutic intervention.
爱泼斯坦-巴尔病毒（EBV）相关的移植后淋巴细胞增殖性疾病（PTLD）日益被认为是血液干细胞移植（HSCT）的一种致命并发症。胸部受累可能是孤立的，也可能是播散性疾病的一部分，通常包括肺结节或肿块以及纵隔淋巴结肿大。本病例研究介绍了2例接受HSCT的患者，1例为同种异体移植，另1例为自体移植，他们均发生了罕见的支气管内EBV相关PTLD。首例患者有一个肉质白色支气管内肿物，导致右上叶肺不张，第二例患者从气管到双侧基底支气管有广泛的坏死性黏膜，CT扫描显示肺实质无明显变化。在这两例中，均通过支气管活检做出诊断。医生应意识到HSCT后EBV相关PTLD的支气管内表现形式，以便能够快速诊断并进行治疗干预。
