Lymphoid interstitial pneumonia after allogeneic bone marrow transplantation. A possible manifestation of chronic graft-versus-host disease.
Interstitial pneumonia (IP) is a frequent and serious complication of bone marrow transplantation with a median time of onset about 2 months posttransplant. Most cases result either from toxicity of radiation and chemotherapy or from infection with pathogens such as cytomegalovirus. Described are two patients with chronic graft-versus-host disease (GVHD) who presented with late-onset IP 242 and 632 days posttransplant. Histologic examination of lung biopsy specimens disclosed a lymphoid interstitial pneumonia (LIP) in both cases. The major lymphocyte subset found in bronchoalveolar lavages and lung tissue was OKT8(+) and showed a positive dot staining for acid phosphatase. Contrary to peripheral blood mononuclear cells, most OKT8(+) lymphocytes in the lungs were OKT3(-). Since acute GVHD lesions are mediated mainly by cytotoxic T-lymphocytes, our data suggest that LIP in marrow-grafted patients may be a manifestation of chronic GVHD. It should be distinguished from the more common types of IP encountered following bone marrow transplantation.
D000135:Acid Phosphatase / Q000032:analysis; D000293:Adolescent; D000328:Adult; D001706:Biopsy; D016026:Bone Marrow Transplantation; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D008168:Lung / Q000473:pathology; D008297:Male; D011658:Pulmonary Fibrosis / Q000209:etiology* / Q000473:pathology; D012129:Respiratory Function Tests; D013601:T-Lymphocytes / Q000473:pathology
D000135:Acid Phosphatase