title: Bronchogenic carcinoma after lung transplantation: frequency, clinical characteristics, and imaging findings.
abstract: OBJECTIVE
  To determine the frequency, clinical characteristics, and radiologic findings of bronchogenic carcinoma in patients surviving more than 1 month after lung transplantation.
  
  
  METHODS
  The study population was composed of 2,168 consecutive patients at seven lung transplantation centers who survived longer than 1 month after lung transplantation. Medical records, chest radiographs, and computed tomographic (CT) scans obtained at the time of diagnosis and prior images when available were reviewed for various items of information and imaging features.
  
  
  RESULTS
  Twenty-four (1%) of the 2,168 patients, all with single-lung transplants, developed cancer in the native lung. Eighteen patients had emphysema, and six had pulmonary fibrosis. The frequencies of cancer in patients with emphysema and fibrosis were 2% (18 of 859 patients) and 4% (six of 147 patients), respectively. Twelve (50%) of their 24 cancers were detected at chest radiography. Fourteen (58%) patients had clinical symptoms. Twenty-one (88%) of the 24 patients had one (n = 11) or more (n = 10) nodules, and nine (38%) had one (n = 8) or more (n = 1) masses visible on CT scans. Nodules and masses were visible on 12 (50%) and seven (29%) of 24 chest radiographs, respectively. Eleven (48%) of 23 cancers for which prior chest radiographs were available were seen retrospectively on prior chest radiographs.
  
  
  CONCLUSIONS
  Bronchogenic carcinoma develops in the native lung of transplant recipients with emphysema and pulmonary fibrosis with frequencies of 2% and 4%, respectively. The carcinomas most commonly manifest as a pulmonary nodule or mass on chest radiographs, with more nodules seen on CT scans.
authors.affiliation: Department of Radiology, University of Wisconsin Hospital and Clinics, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3252, USA. jcollin4@facstaff.wisc.edu
authors.forename: Jannette
authors.initials: J
authors.lastname: Collins
authors.forename: Ella A
authors.initials: EA
authors.lastname: Kazerooni
authors.forename: Joan
authors.initials: J
authors.lastname: Lacomis
authors.forename: H Page
authors.initials: HP
authors.lastname: McAdams
authors.forename: Ann N
authors.initials: AN
authors.lastname: Leung
authors.forename: Maria
authors.initials: M
authors.lastname: Shiau
authors.forename: Janice
authors.initials: J
authors.lastname: Semenkovich
authors.forename: Robert B
authors.initials: RB
authors.lastname: Love
mesh_terms: D000368:Aged; D002283:Carcinoma, Bronchogenic / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging / Q000209:etiology; D011183:Postoperative Complications; D011656:Pulmonary Emphysema / Q000150:complications; D011658:Pulmonary Fibrosis / Q000150:complications; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed