LUNG NODULES AND MASSES AFTER CARDIAC TRANSPLANTATION

Single or multiple lung nodules or masses were noted at chest radiogra phy in 25 (9.7%) of 257 patients after cardiac transplantation. Two ep isodes occurred in each of three patients, for a total of 28 (10.9%) e pisodes in the 257 patients within the first 18 months after transplan tation (transplantation performed between July 1987 and December 1990) . Bronchoscopy, percutaneous needle biopsy, and open lung biopsy were performed as clinically warranted to establish a diagnosis. Infection was found in 21 instances (8.2%) in 18 patients. The most frequent pat hogens were Aspergillus (n = 9 [3.5%]) and Nocardia (n = 7 [2.7%]). As pergillus was hospital acquired in eight (89%) of nine patients and ha d a right-sided predominance (20 [74%] of 27 lesions). The nodules or masses appeared a median of 2 months after transplantation for Aspergi llus (range, 0.5-12 months) and 5 months for No-cardia (range, 1-10 mo nths). B cell lymphoma manifested as numerous nodules in two patients (0.8%). Although a variety of causes were found for post-cardiac trans plantation nodules or masses, the majority (75%) were infectious.