Pulmonary hypertension associated with pulmonary occlusive vasculopathy after allogeneic bone marrow transplantation

• Published in: Transplantation Vol. 69; no. 1; p. 177
• Main Authors: Seguchi, M, Hirabayashi, N, Fujii, Y, Azuno, Y, Fujita, N, Takeda, K, Sato, Y, Nishimura, M, Yamada, K, Oka, Y
• Format: Journal Article
• Language: English
• Published: United States 15.01.2000
• Subjects: Adult; Bone Marrow Transplantation; Fibrosis; Humans; Hypertension, Pulmonary - etiology; Lymphoma, T-Cell - surgery; Male; Postoperative Complications; Pulmonary Circulation; Transplantation, Homologous; Tunica Intima - pathology; Vascular Diseases - etiology; Vascular Diseases - pathology
• ISSN: 0041-1337
• DOI: 10.1097/00007890-200001150-00030

Pulmonary vasculature abnormalities, including pulmonary veno-occlusive disease, have been demonstrated in marrow allograft recipients. However, it is often difficult to make a correct diagnosis of pulmonary lesions. An open lung biopsy was performed on a patient who developed severe pulmonary hypertension after bone marrow transplantation for T-cell lymphoma. An open lung biopsy specimen demonstrated pulmonary arterial occlusion due to intimal fibrosis and veno-occlusion. The most striking alteration was partial to complete occlusion of the small arteries by fibrous proliferation of the intima. High-dose preparative chemotherapy and radiation before transplantation are thought to have contributed to the development of vasculopathy in this patient, because arterial occlusion by intimal fibrosis and atypical veno-occlusion are often associated with lung injury due to chemoradiation. An open lung biopsy is essential for diagnosing pulmonary vascular disease presenting signs compatible with posttransplantation pulmonary hypertension.