Shirafuji Tomoyuki, Kamohara Ryoutarou, Miyazaki Takurou, Oomagari Takeyuki, Ozawa Mutsumi
Department of Surgery, St. Franciscan Hospital, Nagasaki, Japan.
Kyobu Geka. 2021 Apr;74(4):304-307.
A 15-year-old boy who presented recurrent bilateral pneumothoraces after allogenic bone marrow transplantation for the treatment of myelodysplastic syndrome is presented. We performed bulla resection under the thoracoscopic surgery for three times. Pathological examination revealed irregular fibrous thickening of the visceral pleura and alveolar fibrosis, consistent with a diagnosis of pleuroparenchymal fibroelastosis (PPFE). Also the findings of bronchiolitis obliterans (BO) was noted and chronic graftversus-host disease( GVHD) was strongly suggested. Twenty-five months after the operation, bilateral living-donor lobar lung transplantation was performed and the diagnosis of GVHD was established.
本文报告了一名15岁男孩，其在接受异基因骨髓移植治疗骨髓增生异常综合征后反复出现双侧气胸。我们在胸腔镜手术下进行了三次肺大疱切除术。病理检查显示脏层胸膜不规则纤维增厚和肺泡纤维化，符合胸膜实质纤维弹性组织增生症（PPFE）的诊断。此外，还发现了闭塞性细支气管炎（BO），强烈提示存在慢性移植物抗宿主病（GVHD）。术后25个月，进行了双侧活体供体肺叶移植，并确诊为GVHD。
