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Pulmonary Infections After Bone Marrow Transplantation: High-Resolution CT Findings in 111 Patients

Dante L. Escuissato1, Emerson L. Gasparetto1, Edson Marchiori2, Gabriela de Melo Rocha1, César Inoue1, Ricardo Pasquini3 and Nestor L. Müller4

1 Department of Diagnostic Radiology, the University of Parana, Curitiba, Brazil.
2 Department of Diagnostic Radiology, the University of Rio de Janeiro, Rio de Janeiro, Brazil.
3 Bone Marrow Transplantation Unit, the University of Parana, Curitiba, Brazil.
4 Department of Radiology, Vancouver General Hospital, 899 W 12th Ave., Vancouver, BC V5Z 1M9, Canada.



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  		Fig. 1 —28-year-old woman with invasive aspergillosis 104 days after bone marrow transplantation. High-resolution CT scan obtained at level of middle lobe shows large nodule surrounded by ground-glass attenuation (arrows) (CT halo sign).

 


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  		Fig. 2 —15-year-old boy with Aspergillus infection 133 days after bone marrow transplantation. High-resolution CT scan obtained at level of pulmonary veins shows large nodule with irregular margins in lingula and several small nodules. Some small nodules are centrilobular (curved arrows), and some are in a random distribution (straight arrow).

 


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  		Fig. 3 —25-year-old woman with Pseudomonas aeruginosa pneumonia 18 days after bone marrow transplantation. High-resolution CT scan obtained at level of main bronchi shows multiple bilateral nodules of variable sizes, some of them with surrounding ground-glass attenuation.

 


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  		Fig. 4 —22-year-old woman with Staphylococcus aureus pneumonia 46 days after bone marrow transplantation. High-resolution CT scan of right lung shows focal areas of air-space consolidation in right upper lobe.

 


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  		Fig. 5 —40-year-old man with respiratory syncytial virus pneumonia 57 days after bone marrow transplantation. High-resolution CT scan obtained at level of main bronchi shows multiple small nodules in right upper lobe (arrows) and areas of air-space consolidation associated with ground-glass attenuation in left upper lobe.

 


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  		Fig. 6 —20-year-old woman with respiratory syncytial virus pneumonia 33 days after bone marrow transplantation. High-resolution CT scan obtained at level of left upper lobe bronchus shows bronchial wall thickening (arrowheads).

 


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  		Fig. 7 —38-year-old man with cytomegalovirus pneumonia 49 days after bone marrow transplantation. High-resolution CT scan obtained at level of pulmonary veins shows multiple small nodules (arrows).

 


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  		Fig. 8 —38-year-old man with cytomegalovirus pneumonia 62 days after bone marrow transplantation. High-resolution CT scan obtained at level of main bronchi shows diffuse ground-glass attenuation superimposed on mild centrilobular emphysema.

 

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