Non‐specific interstitial pneumonia as a manifestation of graft‐versus‐host disease following pediatric allogeneic hematopoietic stem cell transplantation |
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Authors: | Aya Miyagawa‐Hayashino Makoto Sonobe Takeshi Kubo Akihiko Yoshizawa Hiroshi Date Toshiaki Manabe |
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Institution: | 1. Departments of Diagnostic Pathology,;2. Thoracic Surgery, and;3. Radiology, Kyoto University Hospital, Kyoto, Japan |
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Abstract: | Bronchiolitis obliterans (BO) is generally believed to be a marker of pulmonary manifestation of graft‐versus‐host disease (GVHD) in patients who have undergone bone marrow transplantation for hematological malignancy. Pulmonary manifestations reported as GVHD (other than BO) include lymphocytic bronchiolitis with cellular interstitial pneumonia, lymphoid interstitial pneumonia, veno‐occlusive disease, and diffuse alveolar damage. Morphological reactions in the lungs of bone marrow transplant recipients associated with interstitial pneumonia have not been described systematically. Reported herein is a fibrosing non‐specific interstitial pneumonia (NSIP) pattern together with BO in both lungs in an 8‐year‐old girl following a second allogeneic hematopoietic stem cell transplantation for relapsed neuroblastoma of adrenal origin. The course was complicated by bilateral pneumothoraces, and the patient underwent lung transplantation 3 years after the second stem cell transplantation. Because the patient had chronic GVHD of the skin and the liver preceeded by the development of pulmonary involvement, NSIP may represent one of the facets of pulmonary GVHD. |
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Keywords: | chronic graft‐versus‐host disease interstitial pneumonia pneumothorax umbilical cord blood transplantation |
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