[Differential diagnosis of round opacities after lung transplantation].
Incidence, aetiology, diagnosis and treatment of round lesions in the lungs were analysed in 64 patients after lung transplantation (33 men, 31 women; mean age 45 [21-68] years; postoperative survival > 2 weeks). These lesions were found in 8 patients 1-10 months (median of 5.8 months) after the transplantation, singly in two, multiple in six. In six patients it was an incidental finding, further elucidated by computed tomography or fine-needle biopsy. The aetiology varied from B-cell "lymphoma" (posttransplant lymphoproliferative disorder-PTLD) in three patients, aspergilloma in two, and bacterial abscess in one. Two patients died of septicaemia (Aspergillus; Pseudomonas aeruginosa/Staphylococcus aureus), while four had a full remission. The solitary lesions disappeared without specific treatment in 2-3 weeks. If round lesions are noted after lung transplantation, rapid histological and microbiological diagnosis and aggressive treatment are necessary to combat an otherwise high death-rate. PTLD and infection (bacterial or mycotic) are the most frequent causes.
End
A
A
II Chirurgische Klinik, Universität Wien.
Dekan
G
G
Korn
M
M
Helbich
T
T
Grabenwöger
M
M
Mitterbauer
G
G
Stift
A
A
Mares
P
P
Wekerle
T
T
Wolner
E
E
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000382:microbiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015994:Incidence; D008171:Lung Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology / Q000401:mortality / Q000628:therapy; D008172:Lung Diseases, Fungal / Q000382:microbiology; D016040:Lung Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000209:etiology; D008297:Male; D008875:Middle Aged
Differentialdiagnose von Rundherden nach Lungentransplantation.