High-resolution computed tomography of bronchiolitis obliterans syndrome after bone marrow transplantation

Abstract

High-resolution computed tomography (HRCT) has been described to be useful in assessing bronchiolitis obliterans (BO) syndrome in the transplanted lung. Currently, BO syndrome is diagnosed if lung function deterioration shows persistent or progressive irreversible airflow obstruction, with FEV1 of less than 80% of baseline values, without clinical evidence of infection. The aim of this study is to assess the value of HRCT in evaluating BO syndrome after allogenic bone marrow transplantation (BMT). Fourteen HRCT scans were performed in 6 women and 3 men with moderately severe irreversible airflow obstruction and a clinical diagnosis of BO syndrome after BMT. Two patients had normal HRCT scans. In the remaining 7 patients, 7 of 11 HRCT scans were abnormal, with non-specific findings of bronchial dilatation (1), consolidation (2), hypoattenuated areas (4) and vascular attenuation (4). In comparison with the consistency of positive HRCT findings of BO syndrome in transplanted lungs, HRCT surveillance for BO syndrome in post-BMT patients with clinically established disease is of limited value, unless other pulmonary complications such as opportunistic infections are to be excluded.