The histological spectrum of pulmonary graft-versus-host disease in bone marrow transplant recipients.
The histological changes in 17 biopsy specimens of the lung showing graft-versus-host disease (GVHD) in bone marrow transplant (BMT) recipients were reviewed and correlated with the patients' clinical courses. These morphological changes fell into four transplant-related categories: diffuse alveolar damage, lymphocytic bronchitis/bronchiolitis with interstitial pneumonitis, bronchiolitis obliterans organizing pneumonia, and cicatricial bronchiolitis obliterans. Pulmonary disease correlated with the presence of GVHD at extrathoracic sites. Patients with active lymphocytic bronchitis/bronchiolitis, cicatricial bronchiolitis obliterans, and diffuse alveolar damage had particularly poor outcomes. A proposal is offered for the categorization of the pulmonary damage caused by GVHD in BMT recipients.
Yousem
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Department of Pathology, Montefiore University Hospital, University of Pittsburgh Medical Center, PA 15213-2582, USA.
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D016026:Bone Marrow Transplantation / Q000473:pathology*; D001991:Bronchitis / Q000473:pathology; D005260:Female; D006086:Graft vs Host Disease / Q000473:pathology*; D006801:Humans; D008171:Lung Diseases / Q000473:pathology*; D017563:Lung Diseases, Interstitial / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000473:pathology