1."Crazy-Paving" Patterns on High-Resolution CT Scans in Patients with Pulmonary Complications after Hematopoietic Stem Cell Transplantation.
Edson MARCHIORI ; Dante L ESCUISSATO ; Taisa Davaus GASPARETTO ; Daniela Peixoto CONSIDERA ; Tomas FRANQUET
Korean Journal of Radiology 2009;10(1):21-24
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.
Adolescent
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Adult
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Female
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Hematopoietic Stem Cell Transplantation/*adverse effects
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Humans
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Lung/*radiography
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Lung Diseases/etiology/*radiography
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Male
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Middle Aged
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Pneumonia/etiology/radiography
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Pulmonary Edema/etiology/radiography
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Respiratory Tract Infections/etiology/radiography
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*Tomography, X-Ray Computed
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Young Adult