Tuberc Respir Dis.  2009 Feb;66(2):122-126.

A Case of Nonclassifiable Interstitial Pneumonia after Allogeneic Hematopoietic Stem Cell Transplantation

• Jung KH
• Sung HJ
• Lee JH
• Han J
• Shin C
• Park HJ
• Kim JH

Abstract

Despite the improvements in supportive care, early and late hematopoietic stem cell transplantation-related complications still remain a significant cause of morbidity and mortality. Pulmonary complications occur in 40~60% of patients who undergo allogeneic hematopoietic stem cell transplantation. Late-onset noninfectious pulmonary complications can occur months and even years after transplantation. Interstital lung disease has also been reported to be a late post-transplant complication. Exposure to cytotoxic drugs and/or irradiation has been implicated as a cause of pulmonary toxicity including pulmonary fibrosis. We report a case of an 18-year-old female with non-classifiable interstitial pneumonia that manifested eight and a half years after allogeneic hematopoietic stem cell transplantation. The condition worsened rapidly and the patient eventually died.

Keyword

Hematopoietic stem cell transplantation; Interstitial lung disease; Pneumothorax

MeSH Terms

Adolescent
Female
Hematopoietic Stem Cell Transplantation
Hematopoietic Stem Cells
Humans
Lung Diseases
Lung Diseases, Interstitial
Pneumothorax
Pulmonary Fibrosis
Transplants

Figure

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  Figure 1 Chest radiograph on admission (A) showed reticulonodular opacities on both upper lung zones and patchy opacities with consolidation on left mid to lower lung zone. After 2 months (B), recurrent pneumothoraxes were developed and progressive bilateral haziness worsened until 5 months after admission (C), resulting in death.

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  Figure 2 High resolution computed tomography of chest on admission showed reticulonodular opacities on both upper lobes (A), ground glass opacity with consolidation on left lower lobe (B) and aggravated air cysts on right lower lobe (C).

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  Figure 3 Histopathology of the resected left lower lobe revealed chronic inflammation with alveolar macrophages in alveolar space and focal interstitial fibrosis. Subpleural and peribronchiolar collagen type fibrosis with some lymphocytic infiltration was seen (H&E stain, A: ×200, B: ×400).

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