Chest computed tomography of late invasive aspergillosis after allogeneic hematopoietic stem cell transplantation.
Computed tomography (CT) is a powerful diagnostic tool for invasive aspergillosis (IA) after allogeneic stem cell transplantation (allo-SCT); however, little information is available concerning CT findings of late IA after allo-SCT. To characterize CT findings of late IA, we retrospectively examined medical records and high-resolution CT findings of 27 allo-SCT recipients with late IA. Either acute or chronic GVHD was diagnosed in 24 patients. All 27 patients were given corticosteroids at IA diagnosis. High-resolution CT findings included halo (n=12), centrilobular nodules (n=12), ill-defined consolidation (n=13), ground-glass attenuation (n=8), pleural effusion (n=7), pleural-based consolidation (n=4), and cavitation (n=4). CT findings showing centrilobular nodules and either halo or cavitation were classified into bronchopneumonia type and angioinvasive type, respectively. Angioinvasive-type, bronchopneumonia-type, and combination-type IA were diagnosed in 11, 8, and 4 patients, respectively. CT findings were nonspecific in the other 4 patients. One bronchopneumonia-type case and 2 angioinvasive-type IA cases were subsequently diagnosed as combination type. Although there were no significant differences in patient characteristics between the 2 types of IA, bronchopneumonia-type IA had a poorer prognosis than angioinvasive IA ( P=.022). Halo is a useful diagnostic marker in late IA as well as early IA, and late IA frequently manifests as bronchopneumonia.
Kojima
Rie
R
Hematopoietic Stem Cell Transplantation Unit, The National Cancer Center Hospital, Tokyo, Japan.
Tateishi
Ukihide
U
Kami
Masahiro
M
Murashige
Naoko
N
Nannya
Yasuhito
Y
Kusumi
Eiji
E
Sakai
Miwa
M
Tanaka
Yuji
Y
Kanda
Yoshinobu
Y
Mori
Shin-Ichiro
S
Chiba
Shigeru
S
Kusumoto
Masahiko
M
Miyakoshi
Shigesaburo
S
Hirai
Hisamaru
H
Taniguchi
Shuichi
S
Sakamaki
Hisashi
H
Takaue
Yoichi
Y
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D001228:Aspergillosis / Q000000981:diagnostic imaging* / Q000473:pathology; D001996:Bronchopneumonia / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology; D005260:Female; D006086:Graft vs Host Disease / Q000382:microbiology / Q000517:prevention & control; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology; D013909:Thorax / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D014184:Transplantation, Homologous
D000305:Adrenal Cortex Hormones