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

Purpose: 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.

Materials And Methods: 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.

Results: 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.

Conclusion: 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.