title: Pulmonary hypertension associated with pulmonary occlusive vasculopathy after allogeneic bone marrow transplantation.
abstract: BACKGROUND
  Pulmonary vasculature abnormalities, including pulmonary veno-occlusive disease, have been demonstrated in marrow allograft recipients. However, it is often difficult to make a correct diagnosis of pulmonary lesions.
  
  
  METHODS
  An open lung biopsy was performed on a patient who developed severe pulmonary hypertension after bone marrow transplantation for T-cell lymphoma.
  
  
  RESULTS
  An open lung biopsy specimen demonstrated pulmonary arterial occlusion due to intimal fibrosis and veno-occlusion. The most striking alteration was partial to complete occlusion of the small arteries by fibrous proliferation of the intima.
  
  
  CONCLUSIONS
  High-dose preparative chemotherapy and radiation before transplantation are thought to have contributed to the development of vasculopathy in this patient, because arterial occlusion by intimal fibrosis and atypical veno-occlusion are often associated with lung injury due to chemoradiation. An open lung biopsy is essential for diagnosing pulmonary vascular disease presenting signs compatible with posttransplantation pulmonary hypertension.
authors.affiliation: Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Seguchi
authors.forename: N
authors.initials: N
authors.lastname: Hirabayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Fujii
authors.forename: Y
authors.initials: Y
authors.lastname: Azuno
authors.forename: N
authors.initials: N
authors.lastname: Fujita
authors.forename: K
authors.initials: K
authors.lastname: Takeda
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.forename: M
authors.initials: M
authors.lastname: Nishimura
authors.forename: K
authors.initials: K
authors.lastname: Yamada
authors.forename: Y
authors.initials: Y
authors.lastname: Oka
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation; D005355:Fibrosis; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology*; D016399:Lymphoma, T-Cell / Q000601:surgery; D008297:Male; D011183:Postoperative Complications; D011652:Pulmonary Circulation; D014184:Transplantation, Homologous; D017539:Tunica Intima / Q000473:pathology; D014652:Vascular Diseases / Q000209:etiology* / Q000473:pathology