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The utility of lung biopsy in recipients of stem cell transplantation
- Source :
- Journal of pediatric surgery. 36(8)
- Publication Year :
- 2001
-
Abstract
- Background/Purpose: Pulmonary infiltrates in recipients of stem cell transplantation often present as diagnostic dilemmas. Although lung biopsy may establish the diagnosis of parenchymal disease, it remains unclear whether such a procedure results in a significant change in the patient's treatment and outcome. This study evaluates the efficacy of lung biopsy in recipients of stem cell transplantation. Methods: The medical records of 15 stem cell transplant recipients who underwent 18 lung biopsies were reviewed. The indications for stem cell transplantation were leukemia in 10 patients, lymphoma in 2, histiocytosis in 1, neuroblastoma in 1, and Ewing's sarcoma in 1. The results of the lung biopsies were correlated to the clinical management and outcomes. Results: The overall mortality rate was 67% (10 patients). Eight of the 9 patients who required mechanical ventilatory support at the time of lung biopsy died. The pathologic diagnoses were pneumonitis in 6 biopsies, fibrosis in 6, brochiolitis obliterans organizing pneumonia in 3, hemorrhage in 2, and infarction in 1. Therapy was changed in 1 patient who improved after a course of steroids for bronchiolitis obliterans organizing pneumonia. Lung biopsy cultures were positive in 6 patients but rarely resulted in changes in antibiotic therapy. Conclusions: Results of very few lung biopsies performed in stem cell transplant recipients redirected therapy. Furthermore, the ultimate outcome of these patients were not improved by the results of lung biopsies. J Pediatr Surg 36:1302-1303. Copyright © 2001 by W.B. Saunders Company.
- Subjects :
- Male
medicine.medical_specialty
Adolescent
Pulmonary Edema
Lung biopsy
Risk Assessment
Sensitivity and Specificity
Biopsy
medicine
Humans
Child
Lung
Pneumonitis
Retrospective Studies
medicine.diagnostic_test
business.industry
Biopsy, Needle
Hematopoietic Stem Cell Transplantation
Bronchiolitis obliterans organizing pneumonia
General Medicine
medicine.disease
Prognosis
Surgery
Transplantation
Survival Rate
medicine.anatomical_structure
Child, Preschool
Hematologic Neoplasms
Pediatrics, Perinatology and Child Health
Female
Sarcoma
Stem cell
business
Subjects
Details
- ISSN :
- 00223468 and 13021303
- Volume :
- 36
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Journal of pediatric surgery
- Accession number :
- edsair.doi.dedup.....cc593e0e857a6ed8824514f085980e39