Graft-Versus-Host Disease of the Lung after Allogeneic Hematopoietic Stem Cell Transplantation - A Report of Two Cases -
노지현, 한정호, 유건희, 안강모, 김지혜,
소속 상세정보
노지현 ( Roh Ji-Hyeon )
성균관대학교 의과대학 삼성서울병원 병리학교실
한정호 ( Han Joung-Ho )
성균관대학교 의과대학 삼성서울병원 병리학교실
유건희 ( Yoo Keon-Hee )
성균관대학교 의과대학 삼성서울병원 소아과학교실
안강모 ( Ahn Kang-Mo )
성균관대학교 의과대학 삼성서울병원 소아과학교실
김지혜 ( Kim Ji-Hye )
성균관대학교 삼성서울병원 영상의학과
KMID : 0357920090430040378
Abstract
Herein, we describe cases of pulmonary acute graft-versus-host disease (aGVHD) in two patients occurring after allogeneic hematopoietic stem cell transplantation (HSCT) due to precursor B-cell acute lymphoblastic leukemia in a 6-year-old patient and in acute myeloid leukemia in a 14-year-old boy. In both cases, chest CT revealed confluent ground-glass attenuation along the bronchovascular bundles, as well as some bronchial dilatation. Microscopically, in both cases we noted a characteristic bronchiolocentric pattern and bronchiolar epithelial changes, which included denudation of the bronchiolar epithelium, regenerating atypical cells, and wall thickening with subepithelial or transmural fibroblast proliferation, along with some lymphocytic infiltration. One patient died on day 86 after allogeneic HSCT due to sudden acute respiratory distress syndrome, and the other patient currently remains alive without active aGVHD. The authors`s experiences in these two cases demonstrate that intense awareness of the pathologic findings of GVHD is mandatory after allogeneic HSCT.
키워드
Graft-versus-host disease;Hematopoietic stem cell transplantation;Leukemia;Lung
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