Uchiyama H, Uchiyama M, Shishikura A, Hoshi Y, Mori Y, Tominaga S
Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan.
Int J Hematol. 1998 Aug;68(2):213-20. doi: 10.1016/s0925-5710(98)00054-1.
Bronchiolitis obliterans (BO) has been described as a main pulmonary complication following allogeneic bone marrow transplantation (BMT). Diagnosis of BO is usually based on clinical findings, pulmonary function tests, and computed tomography scan. However, histological examination of an open-lung biopsy specimen may sometimes be necessary to confirm the diagnosis, despite its relative invasiveness. The ventilation lung scan is another useful but non-invasive diagnostic method. In this study, we present two post-transplant BO cases, each showing different clinical conditions, characterized by delayed wash-out on 133Xe gas and airway depositions on radioaerosol inhalation scans. These methods succeeded in revealing pulmonary obstruction in cases where the pulmonary function tests were within normal range and the high-resolution CT scans (HR-CT) of the chest were only minimally abnormal, suggesting their usefulness as an additional tool in the diagnosis of post-transplant BO, as well as in the follow-up to pulmonary obstruction.
闭塞性细支气管炎（BO）被认为是异基因骨髓移植（BMT）后的主要肺部并发症。BO的诊断通常基于临床表现、肺功能测试和计算机断层扫描。然而，尽管开胸肺活检标本的组织学检查具有一定的侵入性，但有时仍有必要进行此项检查以确诊。通气肺扫描是另一种有用的非侵入性诊断方法。在本研究中，我们展示了两例移植后BO病例，每例表现出不同的临床情况，其特征为¹³³Xe气体洗脱延迟和气溶胶吸入扫描显示气道沉积。这些方法成功地揭示了肺功能测试在正常范围内且胸部高分辨率CT扫描（HR-CT）仅有轻微异常的病例中的肺阻塞情况，表明它们作为移植后BO诊断以及肺阻塞随访的辅助工具是有用的。
