Air-leak syndromes in hematopoietic stem cell transplant recipients with chronic GVHD: high-resolution CT findings.
OBJECTIVE
The purpose of this study was to determine the incidence and the high-resolution computed tomography findings of air-leak syndromes in a large group of hematopoietic stem cell (HSC) transplant recipients with proved chronic graft versus host disease (cGVHD).


METHODS
High-resolution computed tomography scans of 9 allogeneic HSC transplant recipients (8 men, 1 woman; 19 to 45 years of age; median 28 y), with a proven diagnosis of cGVHD-related bronchiolitis obliterans syndrome (BOS) were reviewed for the presence, appearance, and distribution of abnormalities.


RESULTS
Nine patients with cGVHD developed 10 episodes of spontaneous air-leak syndromes secondary to cGVHD-related BOS during the study period analyzed; for a 2-year estimated cumulative incidence of 2.1% (95% confidence interval 0.2% to 3.8%) its prevalence was 5.7% (95%CI: 2.6% to 10.5%). All cases were allogeneic HSC transplant recipients with cGVHD who acquired new respiratory symptoms and/or radiologic abnormalities. Pneumomediastinum and pneumothorax were present in 6 patients. Subcutaneous emphysema was identified in 3 patients and pulmonary interstitial emphysema in 2 patients. A combination of different air-leak syndromes was observed in 6 patients.


CONCLUSIONS
Air-leak syndromes represent an uncommon late complication in HSC transplant recipients with cGVHD-related BOS.
Department of Radiology, Hospital de Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain. tfranquet@santpau.es
Tomás
T
Franquet
Sonia
S
Rodríguez
José M
JM
Hernández
Rodrigo
R
Martino
Ana
A
Giménez
Alberto
A
Hidalgo
Pere
P
Domingo
D000328:Adult; D001989:Bronchiolitis Obliterans / Q000000981:diagnostic imaging* / Q000209:etiology*; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D013577:Syndrome; D014057:Tomography, X-Ray Computed / Q000379:methods*