Inflation-fixed lungs: pathologic-radiologic (CT) correlation of lung transplantation.
Pulmonary infections and lung rejection are the two major complications of lung transplantation. Although the therapies for these two processes differ greatly, they often cannot be differentiated using standard radiography. We applied high resolution CT (HRCT) to seven lung specimens that were obtained from patients who had received a heart-lung transplant. The lungs were fixed by a method that allows for direct one-to-one pathologic-radiologic correlation. We found: (a) that in contrast to the extensive changes present microscopically, acute lung allograft rejection was characterized by only minor changes on HRCT; (b) that bronchiolitis obliterans, the hallmark of chronic lung allograft rejection, was not reliably identifiable on HRCT; (c) that bronchiectasis with associated peribronchial inflammation and fibrosis, a common finding in lung allograft rejection, was identifiable on HRCT, but that the HRCT appearance of this lesion was not specific for rejection; and (d) that pulmonary infections were often identifiable as a mixed airway-interstitial process on HRCT.
Hruban
R H
RH
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Ren
H
H
Kuhlman
J E
JE
Fishman
E K
EK
Wheeler
P S
PS
Baumgartner
W A
WA
Reitz
B A
BA
Hutchins
G M
GM
D000328:Adult; D001987:Bronchiectasis / Q000000981:diagnostic imaging / Q000473:pathology; D001989:Bronchiolitis Obliterans / Q000000981:diagnostic imaging / Q000473:pathology; D001996:Bronchopneumonia / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D003586:Cytomegalovirus Infections / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006084:Graft Rejection; D016041:Heart-Lung Transplantation; D006652:Histological Techniques; D006801:Humans; D007239:Infections; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000473:pathology; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*