Diffuse alveolar hemorrhage in patients with hematological malignancies: HRCT patterns of pulmonary involvement and disease course

Clin Imaging. 2013 Jul-Aug;37(4):680-6. doi: 10.1016/j.clinimag.2012.11.005. Epub 2013 Jan 10.

Abstract

Objective: To analyze high-resolution computed tomography (HRCT) patterns of lung involvement and disease course in patients with hematological malignancies experiencing diffuse alveolar hemorrhage (DAH) after chemotherapy ± allogeneic stem cell transplantation (allo-SCT).

Materials and methods: Sixteen patients experiencing DAH after chemotherapy ± allo-SCT were enrolled. A total of 74 computed tomography (CT) scans obtained before, during, and after onset of DAH were evaluated retrospectively.

Results: CT features of DAH are each, by oneself, nonspecific. However, conjoint bilateral, diffuse, and dependent ground glass opacity ± crazy paving, accompanied by airspace bronchograms, should suggest this complication. The HRCT course comprises a wide range of trends that are not predictive for patient's outcome, but progression of parenchymal consolidations at follow up was more often detrimental.

MeSH terms

  • Adult
  • Aged
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Hematologic Neoplasms / complications*
  • Hematologic Neoplasms / diagnostic imaging
  • Hematologic Neoplasms / therapy
  • Hemorrhage / diagnostic imaging*
  • Hemorrhage / etiology
  • Hemorrhage / therapy
  • Humans
  • Lung Diseases / diagnostic imaging*
  • Lung Diseases / etiology
  • Lung Diseases / therapy
  • Male
  • Middle Aged
  • Platelet Transfusion
  • Pulmonary Alveoli / diagnostic imaging*
  • Retrospective Studies
  • Stem Cell Transplantation
  • Steroids / therapeutic use
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Steroids