title: Pneumatosis cystoides interstitialis: A complication of graft-versus-host disease. A report of two cases.
abstract: BACKGROUND
  Pneumatosis cystoides intestinalis (PCI) is a rare disorder characterized by the presence of multiple gas collections in the subserosal or submucosal intestinal wall of the large or small intestine. We report two cases of PCI in the course of chronic graft-versus-host disease.
  
  
  METHODS
  A 5-year-old girl was treated for acute lymphoblastic leukemia. Twenty-four months after the hematopoietic stem cell transplantation, in the course of graft-versus-host disease, she developed subcutaneous emphysema of the right inguinal and pudendal region. PCI was diagnosed based on a CT examination. A 3-year-old boy was treated for juvenile myelomonocytic leukemia. Fourteen months after the hematopoietic stem cell transplantation he presented with an increased severity of intestinal symptoms, including intermittent bleeding from large intestine. PCI was diagnosed based on a CT exam and was confirmed by a colonoscopy.
  
  
  CONCLUSIONS
  Pneumatosis cystoides interstitialis in the course of chronic graft-versus-host disease has a heterogeneous clinical presentation that does not correlate with results of imaging. CT is a method of choice to diagnose PCI. In patients with PCI, the presence of free air in the peritoneal cavity does not confirm an intestinal perforation.
authors: Chair and Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland.
authors: Katarzyna
authors: K
authors: Laskowska
authors: Małgorzata
authors: M
authors: Burzyńska-Makuch
authors: Anna
authors: A
authors: Krenska
authors: Sylwia
authors: S
authors: Kołtan
authors: Małgorzata
authors: M
authors: Chrupek
authors: Elżbieta
authors: E
authors: Nawrocka
authors: Władysław
authors: W
authors: Lasek
authors: Zbigniew
authors: Z
authors: Serafin