Hepatic injury localized to the field of total lymphoid irradiation.
A 37-year-old woman with severe aplastic anemia underwent allogeneic bone marrow transplantation following cyclophosphamide (CY) and total lymphoid irradiation (TLI). On day +30, a CT scan was carried out because of a mild elevation in liver enzymes, and it revealed a low density area with a sharp border in the left lobe corresponding to the irradiated area. MRI showed a hypersignal intensity on both T1 and T2-weighted images and suggested that hepatic damage was mainly severe fatty change. These abnormalities resolved with no treatment. CY with TLI for adult patients with severe aplastic anemia may induce hepatic injury.
Murata
M
M
Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Japan.
Muramoto
H
H
Kojima
Y
Y
Nishida
T
T
Haneda
M
M
Kanie
T
T
Taji
H
H
Hamaguchi
M
M
Minami
S
S
Imaeda
T
T
Kodera
Y
Y
D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy; D016026:Bone Marrow Transplantation; D003520:Cyclophosphamide / Q000008:administration & dosage; D005234:Fatty Liver / Q000209:etiology*; D005260:Female; D006801:Humans; D019190:Iron Overload / Q000150:complications; D008099:Liver / Q000528:radiation effects*; D008111:Liver Function Tests; D015182:Lymphatic Irradiation / Q000009:adverse effects*; D011832:Radiation Injuries / Q000209:etiology*; D016879:Salvage Therapy; D065227:Transfusion Reaction; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014184:Transplantation, Homologous
D003520:Cyclophosphamide