2017 Volume 31 Issue 6 Pages 735-740
We report the case of a 49-year-old man who received allogeneic bone marrow transplantation 5 years previously in the Department of Hematology of our hospital. There was no problem during his clinical course after transplantation, especially chronic GVHD, so he did not receive a regular check-up involving chest radiograph or CT for 4 years. Because of dyspnea on exertion starting 2 months before consultation, he underwent chest radiograph and pneumothorax was pointed out on the right side. We inserted a chest tube and operated on the pleurodesis; the right pneumothorax was subsequently resolved. However, left pneumothorax developed 3 months later, and so VATS (video-assisted thoracic surgery) was performed due to persistent air leakage after chest tube drainage. His lung showed subpleural parenchymal fibrosis with upper lobe predominance, suggesting his condition to be a late-onset noninfectious pulmonary complication after bone marrow transplantation.
Recently, some cases of subpleural parenchymal fibrosis with upper lobe predominance after bone marrow transplantation were reported, but the relationship with chronic GVHD remains unclear. We suggest that accumulating similar cases is important.
