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KMID : 0880420090100010021
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Korean Journal of Radiology
2009 Volume.10 No. 1 p.21 ~ p.24
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Crazy-Paving" Patterns on High-Resolution CT Scans in Patients with Pulmonary Complications after Hematopoietic Stem Cell Transplantation
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Edson Marchiori
Dante L. Escuissato
Taisa Davaus Gasparetto
Daniela Peixoto Considera
Tomas Franquet
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Abstract
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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.
Result : 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.
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KEYWORD
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Hematopoietic stem cell transplantation, High-resolution computed tomography, Crazy-paving pattern, Lung, infection
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