Aspergillus infection of the respiratory tract after lung transplantation: chest radiographic and CT findings

被引:27
作者
Diederich, S
Scadeng, M
Dennis, C
Stewart, S
Flower, CDR
机构
[1] Papworth Hosp, Dept Radiol, Cambridge CB3 8RE, England
[2] Papworth Hosp, Dept Pathol, Cambridge CB3 8RE, England
[3] Papworth Hosp, Transplant Unit, Cambridge CB3 8RE, England
关键词
lung transplantation; aspergillosis; CT; chest radiography;
D O I
10.1007/s003300050386
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The objective of our study was to assess radiographic and CT findings in lung transplant patients with evidence of Aspergillus colonization or infection of the airways and correlate the findings with clinical, laboratory, bronchoalveolar lavage, biopsy and autopsy findings. The records of 189 patients who had undergone lung transplantation were retrospectively reviewed for evidence of Aspergillus colonization or infection of the airways. Aspergillus was demonstrated by culture or microscopy of sputum or bronchoalveolar lavage fluid or histologically from lung biopsies or postmortem studies in 44 patients (23%). Notes and radiographs were available for analysis in 30 patients. In 12 of the 30 patients (40%) chest radiographs remained normal. In 11 of 18 patients with abnormal radiographs pulmonary abnormalities were attributed to invasive pulmonary aspergillosis (IPA) in the absence of other causes for pulmonary abnormalities (8 patients) or because of histological demonstration of IPA (3 patients). In these 11 patients initial radiographic abnormalities were focal areas of patchy consolidation (8 patients), ill-defined pulmonary nodules (2 patients) or a combination of both (1 patient). In some of the lesions cavitation was demonstrated subsequently. At CT a "halo" of decreased density was demonstrated in some of the nodules and lesion morphology and location were shown more precisely. Demonstration of Aspergillus from the respiratory tract after lung transplantation does not necessarily reflect IPA but may represent colonization of the airways or semi-invasive aspergillosis. The findings in patients with IPA did not differ from those described in the literature in other immunocompromised patients, suggesting that surgical disruption of lymphatic drainage and nervous supply or effects of preservation and transport of the transplant lung do not affect the radiographic appearances.
引用
收藏
页码:306 / 312
页数:7
相关论文
共 26 条
[21]   PULMONARY NODULES AND THE CT HALO SIGN [J].
PRIMACK, SL ;
HARTMAN, TE ;
LEE, KS ;
MULLER, NL .
RADIOLOGY, 1994, 190 (02) :513-515
[22]   PULMONARY NODULAR OPACITIES AFTER TRANSBRONCHIAL BIOPSY IN PATIENTS WITH LUNG TRANSPLANTS [J].
ROOT, JD ;
MOLINA, PL ;
ANDERSON, DJ ;
SAGEL, SS .
RADIOLOGY, 1992, 184 (02) :435-436
[23]   INVASIVE PULMONARY ASPERGILLOSIS IN AIDS - RADIOGRAPHIC, CT, AND PATHOLOGICAL FINDINGS [J].
STAPLES, CA ;
KANG, EY ;
WRIGHT, JL ;
PHILLIPS, P ;
MULLER, NL .
RADIOLOGY, 1995, 196 (02) :409-414
[24]   BRONCHOCENTRIC MYCOSIS OCCURRING IN TRANSPLANT RECIPIENTS [J].
TAZELAAR, HD ;
BAIRD, AM ;
MILL, M ;
GRIMES, MM ;
SCHULMAN, LL ;
SMITH, CR .
CHEST, 1989, 96 (01) :92-95
[25]   VARIED RADIOLOGIC APPEARANCES OF PULMONARY ASPERGILLOSIS [J].
THOMPSON, BH ;
STANFORD, W ;
GALVIN, JR ;
KURIHARA, Y .
RADIOGRAPHICS, 1995, 15 (06) :1273-1284
[26]   MEDICAL PROGRESS - RECENT ADVANCES IN PULMONARY MEDICINE .2. [J].
WEINBERGER, SE .
NEW ENGLAND JOURNAL OF MEDICINE, 1993, 328 (20) :1462-1470