Pulmonary hypertension associated with pulmonary occlusive vasculopathy after allogeneic bone marrow transplantation

Transplantation. 2000 Jan 15;69(1):177-9. doi: 10.1097/00007890-200001150-00030.


Background: Pulmonary vasculature abnormalities, including pulmonary veno-occlusive disease, have been demonstrated in marrow allograft recipients. However, it is often difficult to make a correct diagnosis of pulmonary lesions.

Methods: An open lung biopsy was performed on a patient who developed severe pulmonary hypertension after bone marrow transplantation for T-cell lymphoma.

Results: An open lung biopsy specimen demonstrated pulmonary arterial occlusion due to intimal fibrosis and veno-occlusion. The most striking alteration was partial to complete occlusion of the small arteries by fibrous proliferation of the intima.

Conclusion: High-dose preparative chemotherapy and radiation before transplantation are thought to have contributed to the development of vasculopathy in this patient, because arterial occlusion by intimal fibrosis and atypical veno-occlusion are often associated with lung injury due to chemoradiation. An open lung biopsy is essential for diagnosing pulmonary vascular disease presenting signs compatible with posttransplantation pulmonary hypertension.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bone Marrow Transplantation*
  • Fibrosis
  • Humans
  • Hypertension, Pulmonary / etiology*
  • Lymphoma, T-Cell / surgery
  • Male
  • Postoperative Complications*
  • Pulmonary Circulation*
  • Transplantation, Homologous
  • Tunica Intima / pathology
  • Vascular Diseases / etiology*
  • Vascular Diseases / pathology