Pulmonary Nodular Lesions in Bone Marrow Transplant Recipients: Impact of Histologic Diagnosis on Patient Management and Prognosis

H. Evin Gulbahce, Stefan E. Pambuccian, Jose Jessurun, Paul Woodard, Marie E. Steiner, J. Carlos Manivel, Stephen Hite, Norma K.C. Ramsay, K. Scott Baker

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Bone marrow transplantation is associated with numerous pulmonary complications, which may manifest as nodules. We studied 33 bone marrow transplant (BMT) recipients in whom pulmonary nodular lesions (PNLs) developed during a 5-year period and who underwent open lung biopsy (OLB) for diagnosis. Of 33 patients with PNL, 15 (45%) had pulmonary cytolytic thrombi (PCT), a recently described condition characterized histologically by occlusive vascular lesions and hemorrhagic infarcts and clinically by a favorable outcome. Clinical symptoms and radiologic abnormalities disappeared during a period of a few weeks. None of the patients died of PCT; 10 were alive at last contact. The second most common cause of PNL (8/33 [24%]) was Aspergillus infection, which was the cause of death in 6. OLB is an effective way of obtaining diagnostic tissue in BMT recipients with PNLs. Histologic examination is accurate in determining the cause of PNLs and identifying lesions that have a favorable outcome and those that require a change in treatment.

Original languageEnglish (US)
Pages (from-to)205-210
Number of pages6
JournalAmerican journal of clinical pathology
Volume121
Issue number2
DOIs
StatePublished - Feb 2004

Keywords

  • Bone marrow transplant
  • Lung
  • Nodules

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