Pulmonary candidiasis after hematopoietic stem cell transplantation: thin-section CT findings.

Abstract

PURPOSE:

To retrospectively evaluate thin-section computed tomographic (CT) findings in hematopoietic stem cell transplant (ie, bone marrow transplant) patients with histopathologically proved pulmonary candidiasis.

MATERIALS AND METHODS:

Ethical approval was obtained from the institutional review board of each of the three institutions; informed consent was not required. The study included 17 hematopoietic stem cell transplant recipients with proved pulmonary candidiasis. Histopathologic specimens were acquired at transbronchial biopsy (n = 8), open lung biopsy (n = 6), and autopsy (n = 3). The patients included seven men and 10 women (age range, 20-62 years; mean age, 37 years). The thin-section CT scans were retrospectively reviewed by two thoracic radiologists for the presence, appearance, and distribution of parenchymal abnormalities.

RESULTS:

Multiple nodules were present in 15 (88%) patients, including centrilobular nodules and tree-in-bud pattern in seven (41%) patients. Nodules were bilateral in 12 patients and unilateral in three. An associated halo of ground-glass opacity was identified in five (33%) patients. Nodules were the only CT finding in five patients (29%). Areas of air-space consolidation were identified in 11 (65%) patients. Areas of ground-glass opacity were seen in six (35%) of 17 patients and were always associated with other abnormalities. Other less common CT findings included pleural effusion (n = 3), thickening of the bronchial walls (n = 2), and cavitation (n = 1).

CONCLUSION:

The most common thin-section CT findings of pulmonary candidiasis in hematopoietic stem cell transplant patients are multiple bilateral nodular opacities often associated with areas of consolidation.

• Authors: Tomás Franquet, Nestor L Müller, Kyung S Lee, Anastasia Oikonomou, Julia D Flint
• Journal: Radiology (Radiology) Vol. 236 Issue 1 Pg. 332-7 (Jul 2005) ISSN: 0033-8419 [Print] United States
• PMID: 15955852 (Publication Type: Journal Article)
• Copyright: Copyright RSNA, 2005

Topics

• Adult
• Biopsy
• Candidiasis (diagnostic imaging)
• Female
• Hematopoietic Stem Cell Transplantation
• Humans
• Immunocompromised Host
• Lung Diseases, Fungal (diagnostic imaging)
• Male
• Middle Aged
• Retrospective Studies
• Tomography, X-Ray Computed