High-resolution computed tomography features of pulmonary chronic graft-versus-host disease following hematopoietic stem cell transplantation: histopathological correlation

Abstract

The purposes of this study were to evaluate the development pattern in patients with multiple episodes of chronic graft-versus-host disease (cGVHD) and to analyze the computed tomography (CT) appearances of the pulmonary parenchymal injury and its relation to treatment response. CT patterns from 41 episodes of cGVHD (25 patients) were evaluated retrospectively and classified into four groups: group 1, airway involvement; group 2, subpleural consolidation or ground glass opacity (GGO); group 3, peribronchovascular/periseptal GGO or consolidations; group 4, others. We analyzed the changing pattern of the CT appearance during multiple episodes and the relation between this CT pattern and response to treatment. None of the patients showed airway involvement (group 1) and pulmonary parenchymal injury patterns (group 2 and 3) simultaneously in one episode. The group 3 CT pattern was more resistant to treatment than that of group 2 (P < 0.05). The pathological basis of the group 3 CT pattern varied but was characterized by mural incorporation fibrosis. Pulmonary cGVHD affected either the airway or pulmonary parenchyma but did not affect both simultaneously in one episode. Of the four patterns, peribronchovascular GGO/consolidations (group 3 CT pattern) was the most resistant to treatment.