"Crazy-paving" patterns on high-resolution CT scans in patients with pulmonary complications after hematopoietic stem cell transplantation.

Abstract

OBJECTIVE:

To describe the pulmonary complications following hematopoietic stem cell transplantation (HSCT) that can present with a "crazy-paving" pattern in high-resolution CT scans.

MATERIALS AND METHODS:

Retrospective review of medical records from 2,537 patients who underwent HSCT. The "crazy-paving" pattern consists of interlobular and intralobular septal thickening superimposed on an area of ground-glass attenuation on high-resolution CT scans. The CT scans were retrospectively reviewed by two radiologists, who reached final decisions by consensus.

RESULTS:

We identified 10 cases (2.02%), seven male and three female, with pulmonary complications following HSCT that presented with the "crazy-paving" pattern. Seven (70%) patients had infectious pneumonia (adenovirus, herpes simplex, influenza virus, cytomegalovirus, respiratory syncytial virus, and toxoplasmosis), and three patients presented with non-infectious complications (idiopathic pneumonia syndrome and acute pulmonary edema). The "crazy-paving" pattern was bilateral in all cases, with diffuse distribution in nine patients (90%), predominantly in the middle and inferior lung regions in seven patients (70%), and involving the anterior and posterior regions of the lungs in nine patients (90%).

CONCLUSION:

The "crazy-paving" pattern is rare in HSCT recipients with pulmonary complications and is associated with infectious complications more commonly than non-infectious conditions.

• Authors: Edson Marchiori, Dante L Escuissato, Taisa Davaus Gasparetto, Daniela Peixoto Considera, Tomas Franquet
• Journal: Korean journal of radiology (Korean J Radiol) 2009 Jan-Feb Vol. 10 Issue 1 Pg. 21-4 ISSN: 1229-6929 [Print] Korea (South)
• PMID: 19182499 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Female
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Lung (diagnostic imaging)
• Lung Diseases (diagnostic imaging, etiology)
• Male
• Middle Aged
• Pneumonia (diagnostic imaging, etiology)
• Pulmonary Edema (diagnostic imaging, etiology)
• Respiratory Tract Infections (diagnostic imaging, etiology)
• Tomography, X-Ray Computed
• Young Adult