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Thin-Section CT Findings in Hematopoietic Stem Cell Transplantation Recipients with Respiratory Virus Pneumonia

Tomas Franquet1, Sonia Rodriguez1, Rodrigo Martino2, Ana Giménez1, Teresa Salinas1 and Alberto Hidalgo1

1 Department of Radiology, Hospital de Sant Pau, Universitat Autónoma de Barcelona, Avda Sant Antoni Ma Claret 167, 08025 Barcelona, Spain.
2 Department of Hematology, Hospital de Sant Pau, Universitat Autónoma de Barcelona, 08025 Barcelona, Spain.


Figure 1
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  		Fig. 1 —48-year-old woman with pneumonia due to parainfluenza A virus infection after hematopoietic stem cell transplantation for acute myeloid leukemia. Transverse thin-section (1-mm collimation) CT scan through hila shows extensive bilateral areas of ground-glass attenuation affecting both upper lobes.

 

Figure 2
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  		Fig. 2 —60-year-old man with parainfluenza 3 infection and severe neutropenia after chemotherapy and hematopoietic stem cell transplantation for myelodysplastic syndrome. Transverse thin-section (1-mm collimation, lung window) CT scan at level of right hilum shows subsegmental area of ground-glass opacity (arrows) in posterior segment of right upper lobe.

 

Figure 3
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  		Fig. 3A —59-year-old man with adenovirus infection after hematopoietic stem cell transplantation for Hodgkin's disease. Transverse thin-section (1-mm collimation, lung window) CT scan obtained at level of lower pulmonary veins shows branching distal structures (tree-in-bud pattern) (arrow).

 

Figure 4
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  		Fig. 3B —59-year-old man with adenovirus infection after hematopoietic stem cell transplantation for Hodgkin's disease. Transverse thin-section (1-mm collimation, lung window) CT scan at level of suprahepatic inferior vena cava shows bilateral multifocal small nodules (arrowhead), branching multiple ill-defined bilateral nodules (black arrow), and thickening of small bronchial walls (white arrow).

 

Figure 5
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  		Fig. 4 —58-year-old man with neutropenia and human metapneumovirus pneumonia after hematopoietic stem cell transplantation. Transverse thin-section (1-mm collimation) CT scan obtained at level of bronchus intermedius shows bilateral areas of ground-glass attenuation and ill-defined centrilobular nodules affecting posterior segment of right upper lobe and both superior segments of lower lobes.

 

Figure 6
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  		Fig. 5 —48-year-old woman with pneumonia due to syncytial respiratory virus infection after hematopoietic stem cell transplantation for non-Hodgkin's lymphoma. Transverse thin-section (1-mm collimation) CT scan of lower left lobe shows small nodules (arrow) and branching centrilobular nodules (tree-in-bud pattern) (arrowheads).

 

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