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Bronchogenic Carcinoma after Lung Transplantation: Frequency, Clinical Characteristics, and Imaging Findings¹

¹ From the Depts of Radiology (J.C.) and Cardiothoracic Surgery (R.B.L.), Univ of Wisconsin Hospital and Clinics, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3252; Dept of Radiology, Univ of Michigan Medical School, Ann Arbor (E.A.K.); Dept of Radiology, Univ of Pittsburgh Medical School, Pa (J.L.); Dept of Radiology, Duke Univ Medical School, Durham, NC (H.P.M.); Dept of Radiology, Stanford Univ Medical School, Stanford, Calif (A.N.L.); Dept of Radiology, College of Physicians and Surgeons of Columbia Univ, New York, NY (M.S.); and Mallinckrodt Inst of Radiology, Washington Univ School of Medicine, St Louis, Mo (J.S.). Received July 13, 2001; revision requested August 13; revision received October 11; accepted October 25. Address correspondence to J.C. (e-mail: jcollin4@facstaff.wisc.edu).

PURPOSE: To determine the frequency, clinical characteristics, and radiologic findings of bronchogenic carcinoma in patients surviving more than 1 month after lung transplantation.

MATERIALS AND METHODS: The study population was composed of 2,168 consecutive patients at seven lung transplantation centers who survived longer than 1 month after lung transplantation. Medical records, chest radiographs, and computed tomographic (CT) scans obtained at the time of diagnosis and prior images when available were reviewed for various items of information and imaging features.

RESULTS: Twenty-four (1%) of the 2,168 patients, all with single-lung transplants, developed cancer in the native lung. Eighteen patients had emphysema, and six had pulmonary fibrosis. The frequencies of cancer in patients with emphysema and fibrosis were 2% (18 of 859 patients) and 4% (six of 147 patients), respectively. Twelve (50%) of their 24 cancers were detected at chest radiography. Fourteen (58%) patients had clinical symptoms. Twenty-one (88%) of the 24 patients had one (n = 11) or more (n = 10) nodules, and nine (38%) had one (n = 8) or more (n = 1) masses visible on CT scans. Nodules and masses were visible on 12 (50%) and seven (29%) of 24 chest radiographs, respectively. Eleven (48%) of 23 cancers for which prior chest radiographs were available were seen retrospectively on prior chest radiographs.

CONCLUSION: Bronchogenic carcinoma develops in the native lung of transplant recipients with emphysema and pulmonary fibrosis with frequencies of 2% and 4%, respectively. The carcinomas most commonly manifest as a pulmonary nodule or mass on chest radiographs, with more nodules seen on CT scans.

© RSNA, 2002

Index terms: Lung, abnormalities, 60.3211, 60.3212, 60.3213, 60.3215, 60.3217, 60.3235, 3237 • Lung, CT, 60.12112, 60.12115, 60.12118, 60.12119 • Lung neoplasms, 60.3211, 60.3212, 60.3213, 60.3215, 60.3217, 60.3235, 3237 • Lung transplantation, 60.458 • Transplantation, 60.458

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