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Pulmonary Histopathologic Findings in Pediatric Patients After Hematopoietic Stem Cell Transplantation: An Autopsy Study.
Cortes-Santiago, Nahir; Patel, Kalyani R; Wu, Hao; Sartain, Sarah E; Bhar, Saleh; Silva-Carmona, Manuel; Pogoriler, Jennifer.
Afiliación
  • Cortes-Santiago N; Department of Pathology and Immunology, Texas Children's Hospital, Houston, TX, USA.
  • Patel KR; Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA.
  • Wu H; Department of Pathology and Immunology, Texas Children's Hospital, Houston, TX, USA.
  • Sartain SE; Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA.
  • Bhar S; Department of Pathology, Yale School of Medicine and Yale New Haven Hospital, New Haven, CT, USA.
  • Silva-Carmona M; Department of Pediatrics, Section of Hematology/Oncology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA.
  • Pogoriler J; Department of Pediatrics, Section of Hematology/Oncology and Critical Care Medicine, Bone Marrow Transplantation, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA.
Pediatr Dev Pathol ; 26(4): 362-373, 2023.
Article en En | MEDLINE | ID: mdl-37165556
BACKGROUND: Pathologic characterization of pulmonary complications following hematopoietic stem cell transplantation (HSCT) is limited. We describe lung findings in pediatric patients who died following HSCT and attempt to identify potential clinical associations. METHODS: Pathology databases at Texas Children's Hospital and the Children's Hospital of Philadelphia were queried (2013-2018 CHOP and 2017-2018 TCH). Electronic medical records and slides were reviewed. RESULTS: Among 29 patients, 19 received HSCT for hematologic malignancy, 8 for non-malignant hematologic disorders, and 2 for metastatic solid tumors. Twenty-five patients (86%) showed 1 or more patterns of acute and organizing lung injury. Sixty-two percent had microvascular sclerosis, with venous involvement noted in most cases and not correlating with clinical history of pulmonary hypertension, clinical transplant-associated thrombotic microangiopathy, irradiation, or graft-versus-host disease. Features suggestive of graft-versus-host-disease were uncommon: 6 patients had lymphocytic bronchiolitis, and only 2 patients had evidence of bronchiolitis obliterans (both clinically unexpected), both with a mismatched unrelated donor transplant. CONCLUSIONS: Acute and subacute alveolar injury (diffuse alveolar damage or organizing pneumonia) is common in pediatric patients who died following HSCT and is difficult to assign to a specific etiology. Microvascular sclerosis was frequent and did not correlate with a single distinct clinical feature.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Prognostic_studies Idioma: En Revista: Pediatr Dev Pathol Asunto de la revista: PATOLOGIA / PEDIATRIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Prognostic_studies Idioma: En Revista: Pediatr Dev Pathol Asunto de la revista: PATOLOGIA / PEDIATRIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos