Korean J Hematol.  2006 Mar;41(1):61-65. 10.5045/kjh.2006.41.1.61.

Recurrent Pneumomediastinum and Subcutaneous Emphysema Complicating Chronic Graft versus Host Disease after Allogeneic Bone Marrow Transplantation

• Lee NR
• Lee TH
• Song EK
• Kwak JY
• Yim CY

• KMID: 2252330
• DOI: http://doi.org/10.5045/kjh.2006.41.1.61

Abstract

Several noninfectious pulmonary complications can be associated with chronic graft versus host disease (GVHD). Obstructive airway disease can be a clinical feature of chronic GVHD and the histopathology reveals characteristic lesions of bronchiolitis obliterans. Bronchiolitis obliterans is an obstructive pulmonary disorder affecting the small airways, and it was first described as a late complication of allogeneic bone marrow transplantation (BMT). Spontaneous pneumomediastinum and subcutaneous emphysema can occur in the setting of severe bronchiolitis obliterans and only rarely are they the first sign of such disease. We describe here a case of a 27-year old woman who developed recurrent pneumomediastinum and subcutaneous emphysema that were secondary to the bronchiolitis obliterans that complicated chronic GVHD after allogeneic BMT.

Keyword

Pneumomediastinum; Subcutaneous emphysema; Bronchiolitis obliterans; Chronic graft versus host disease; Allogeneic bone marrow transplantation

MeSH Terms

Adult
Bone Marrow Transplantation*
Bone Marrow*
Bronchiolitis Obliterans
Female
Graft vs Host Disease*
Humans
Mediastinal Emphysema*
Subcutaneous Emphysema*
Transplants*

Figure

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  Fig. 1 Plain chest radiograph showing subcutaneous emphysema in the neck and upper trunk and pneumomediastinum.

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  Fig. 2 High resolution CT of the chest showing the subcutaneous emphysema and pneumomediastinum at first event.

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  Fig. 3 High resolution CT of the chest showing the recurred subcutaneous emphysema and pneumomediastinum.

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  Fig. 4 High resolution CT of the chest showing bronchial wall thickening and dilatation in the both lung field at one year later.

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