ABSTRACT
We report 4 cases of acute lobar torsion in patients who had undergone bilateral lung transplantation. Bronchoscopy showed complete obstruction in only 2 of them. Torsion was confirmed by computed tomography in coronal minimal and maximal intensity projections with reconstruction. At operation, 1 detorsion and 3 lobectomies were carried out. Early diagnosis and rapid surgical intervention can save the affected lobe.
Subject(s)
Lung Diseases/surgery , Lung Transplantation/adverse effects , Torsion Abnormality/surgery , Adolescent , Adult , Bronchoscopy , Early Diagnosis , Hemorrhage/etiology , Hemorrhage/surgery , Humans , Lung Diseases/diagnosis , Lung Diseases/etiology , Male , Reoperation , Thoracotomy , Tomography, X-Ray Computed , Torsion Abnormality/diagnosis , Torsion Abnormality/etiology , Tracheostomy , Treatment OutcomeABSTRACT
We describe 2 patients with neurofibromatosis type 1 (NF1) who underwent lung transplantation. Case 1 reports a patient with NF1 with no complications 5 years after bilateral lung transplantation. Case 2 details a patient with NF1 diagnosed with both post-transplant lymphoproliferative disorder (PTLD) and massive intra-abdominal sarcoma consistent with a malignant nerve sheath tumor 9 months after lung transplantation. There was no clinical evidence of sarcoma preceding or immediately following lung transplant as demonstrated by a normal abdominal sonogram 3 months post-transplantation. Although an increased risk for cancer has been documented in NF1, the rapid malignant degeneration of a neurofibroma following transplantation raises concern about immunosuppression and transplantation candidacy among individuals with NF1.
