A. Toren et al., BRONCHIOLITIS OBLITERANS PRESENTING AS SUBCUTANEOUS EMPHYSEMA AND PNEUMOMEDIASTINUM - A CASE-REPORT, Medical oncology, 13(4), 1996, pp. 195-197
We describe a woman post allogeneic bone marrow transplantation (BMT),
who presented to the emergency room with subcutaneous emphysema and p
neumomediastinum as the first manifestation of bronchiolitis obliteran
s complicating mild chronic graft versus host disease (GVHD). In contr
ast to other patients with pneumomediastinum described in the literatu
re, this patient suffered from only mild GVHD. She did not receive met
hotrexate as GVHD prophylaxis, and the peumomediastinum was a presenti
ng manifestation rather than a terminal event. In addition, this is th
e first description of subcutaneous emphysema with this setting. There
fore, bronchiolitis obliterans should be highly suspected in post-BMT
patients presenting with pneumomediastinum and subcutaneous emphysema,
and prompt therapy should be initiated.