Clinical and imaging characteristics of hematologic disease complicated by air leak syndrome

Abstract

There are limited systematic studies on hematologic disease complicated by air leak syndrome (ALS). Physicians in radiology departments and hematology departments have a limited awareness of ALS. The aim of this study was to explore the similarities and differences in clinical data between the clinical group and imaging group in patients with hematologic disease complicated by ALS. Clinical and CT data for 59 patients with hematologic disease complicated by ALS in our hospital were retrospectively reviewed. Patients were assessed by clinical grouping and image grouping. Data were compared between groups, and P < .05 was considered statistically significant. Dyspnea occurred more often in the allo-HSCT (allogeneic hematopoietic stem cell transplantation) group than that in the non–allo-HSCT group (68.8% vs 4.7%, P < .001), there were statistically significant differences in inducing factors between groups, and differences in other aspects were not statistically significant. Chest tightness and dyspnea occurred more often in the allo-HSCT with BO/BOOP (bronchiolitis Obliteran/bronchiolitis obliterans organizing pneumonia) group than those in the allo-HSCT without BO/BOOP group (80.0% vs 9.1%, P = .013), and differences in other aspects were not statistically significant. Chest pain occurred more often in the HPT (hydropneumothorax) group than that in the other 3 groups (pure pneumothorax [PT], pulmonary interstitial emphysema [PIE], complex ALS) (71.4% vs 11.1%, 0.0%, and 26.5%, P = .005); ALS thickness in the HPT group was greater than that in the other 2 groups (PIE and complex ALS) (19.7 vs 3.5 cm and 9.5 cm, P = .001); catheter drainage occurred more often in the HPT group than that in the other three groups (PT, PIE, complexALS) (64.3% vs 22.2%, 0.0%, and 2.9%, P = .001). ALS is a high risk in male patients who have a low BMI, have leukemia as a basic disease, and have basic lung diseases (eg, BO/BOOP). CT types are mainly complex ALS, HPT, and pure PT. In addition, clinical symptoms for patients in the HPT group are severe, and there is a high prevalence of catheter drainage.

A Systematic Review on Pulmonary Complications Secondary to Hematopoietic Stem Cell Transplantation

“…Clinically, patients present cough, dyspnea, chest pain, or chest tightness, and radiological abnormalities 100 days post stem cell transplantation with no apparent infectious cause [ 23 ]. These symptoms are caused by lung tissue damage, inflammatory reactions, and the pressure of free air in the cardiopulmonary vessels [ 22 ].…”

“…Its pathogenesis is unknown, but several causes induce these patients to develop ALS. Due to the hematologic disease, the drug treatments taken can induce pulmonary injuries, pulmonary edema, and interstitial pneumonia, causing a more fragile alveolar wall and decreased lung compliance, making patients more vulnerable to developing ALS [ 22 , 23 ]. Clinically, patients present cough, dyspnea, chest pain, or chest tightness, and radiological abnormalities 100 days post stem cell transplantation with no apparent infectious cause [ 23 ].…”

“…A study from January 2014 to December 2018 was conducted at the Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College to analyze clinical and imaging characteristics. They retrospectively analyzed age, sex, height, weight, hematologic disease, numbers of basic treatments, symptoms, type of lung disease, inducing factors, history of allogenic SCT, and types of ALS [ 22 ]. The study reported that ALS has a high rate in young males with low BMI (body mass index), with a male ratio of 68.8% and a mean BMI of 19.4.…”

Computed tomography findings, temporal course, and clinical relevance of subpleural pulmonary interstitial emphysema in patients with pneumomediastinum

“…1 Pulmonary interstitial emphysema can be identified on computed tomography (CT) scans, which show densities consistent with air along the bronchovascular bundles, visceral pleura, and/or interstitial septa. [2][3][4][5][6][7] The CT findings of peribronchovascular PIE have been well described and are useful for differentiating pneumomediastinum due to ruptured alveoli from pneumomediastinum due to other causes. [8][9][10][11] Subpleural PIE has been found on the CT scans of adult patients with spontaneous pneumomediastinum.…”

Effectiveness of thoracic kinesio taping on respiratory function and muscle strength in patients with chronic obstructive pulmonary disease

“…Physiotherapy interventions, such as breathing exercises and early mobilization, aim to restore or maintain muscle function during an acute episode of COPD. [ 3 – 5 ] Physical therapists often use these strategies to relieve dyspnea, improve thoracoabdominal coordination, and enhance functional capacity in patients with COPD exacerbations. [ 6 ]…”