Yu Jin Kim1, Woo Sun Kim2,3,4, Young Hun Choi1,5, Jung-Eun Cheon1,5,6, Jung Yoon Choi7, Hyoung Jin Kang7, Ji-Eun Park1, Young Jin Ryu1, In-One Kim1,5,6. 1. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. 2. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. kimws@snu.ac.kr. 3. Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea. kimws@snu.ac.kr. 4. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. kimws@snu.ac.kr. 5. Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea. 6. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. 7. Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Cancer Research Institute, Seoul National University Children's Hospital, Seoul, Republic of Korea.
Abstract
BACKGROUND: Toxicity of carmustine and cyclophosphamide can cause pulmonary injury after hematopoietic stem cell transplantation. OBJECTIVE: To evaluate the radiologic findings of pulmonary injuries following carmustine- and cyclophosphamide-based preparative regimens in children. MATERIALS AND METHODS: From 2010 to 2014, 35 children received carmustine- and cyclophosphamide-based preparative regimens. Fourteen of 35 children presented with symptoms and radiologic abnormalities. Eight of 14 children had no evidence of infection, cardiogenic edema, or other explainable causes. We retrospectively analyzed their chest radiographs and CT scans for ground-glass opacity, consolidation, septal thickening and pleural effusion. RESULTS: Major chest radiographic findings were bilateral diffuse ground-glass opacity (n=8) and septal thickening (n=7). CT findings were multifocal patchy (n=4) or inhomogeneously diffuse (n=4) ground-glass opacity, multifocal consolidations (n=7) and septal thickening (n=7). All of these lesions at CT were bilateral, but showed lower lobe predominance in 88, 100, and 63%, respectively. There was no central/peripheral or anterior/posterior predilection. Six children had small pleural effusions, which were bilateral in five children. CONCLUSION: Bilateral ground-glass opacity with or without consolidation, septal thickening and pleural effusion were common radiologic findings in pulmonary injury following carmustine- and cyclophosphamide-based preparative regimens.
BACKGROUND: Toxicity of carmustine and cyclophosphamide can cause pulmonary injury after hematopoietic stem cell transplantation. OBJECTIVE: To evaluate the radiologic findings of pulmonary injuries following carmustine- and cyclophosphamide-based preparative regimens in children. MATERIALS AND METHODS: From 2010 to 2014, 35 children received carmustine- and cyclophosphamide-based preparative regimens. Fourteen of 35 children presented with symptoms and radiologic abnormalities. Eight of 14 children had no evidence of infection, cardiogenic edema, or other explainable causes. We retrospectively analyzed their chest radiographs and CT scans for ground-glass opacity, consolidation, septal thickening and pleural effusion. RESULTS: Major chest radiographic findings were bilateral diffuse ground-glass opacity (n=8) and septal thickening (n=7). CT findings were multifocal patchy (n=4) or inhomogeneously diffuse (n=4) ground-glass opacity, multifocal consolidations (n=7) and septal thickening (n=7). All of these lesions at CT were bilateral, but showed lower lobe predominance in 88, 100, and 63%, respectively. There was no central/peripheral or anterior/posterior predilection. Six children had small pleural effusions, which were bilateral in five children. CONCLUSION: Bilateral ground-glass opacity with or without consolidation, septal thickening and pleural effusion were common radiologic findings in pulmonary injury following carmustine- and cyclophosphamide-based preparative regimens.
Authors: David M Hansell; Alexander A Bankier; Heber MacMahon; Theresa C McLoud; Nestor L Müller; Jacques Remy Journal: Radiology Date: 2008-01-14 Impact factor: 11.105
Authors: T Gluecker; P Capasso; P Schnyder; F Gudinchet; M D Schaller; J P Revelly; R Chiolero; P Vock; S Wicky Journal: Radiographics Date: 1999 Nov-Dec Impact factor: 5.333
Authors: R B Jones; S Matthes; E J Shpall; J H Fisher; S M Stemmer; C Dufton; J K Stephens; S I Bearman Journal: J Natl Cancer Inst Date: 1993-04-21 Impact factor: 13.506