"Crazy-Paving" Patterns on High-Resolution CT Scans in Patients with Pulmonary Complications after Hematopoietic Stem Cell Transplantation.
- Author:
Edson MARCHIORI
1
;
Dante L ESCUISSATO
;
Taisa Davaus GASPARETTO
;
Daniela Peixoto CONSIDERA
;
Tomas FRANQUET
Author Information
- Publication Type:Original Article
- Keywords: Hematopoietic stem cell transplantation; High-resolution computed tomography; Crazy-paving pattern; Lung, infection
- MeSH: Adolescent; Adult; Female; Hematopoietic Stem Cell Transplantation/*adverse effects; Humans; Lung/*radiography; Lung Diseases/etiology/*radiography; Male; Middle Aged; Pneumonia/etiology/radiography; Pulmonary Edema/etiology/radiography; Respiratory Tract Infections/etiology/radiography; *Tomography, X-Ray Computed; Young Adult
- From:Korean Journal of Radiology 2009;10(1):21-24
- CountryRepublic of Korea
- Language:English
- 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.
