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Screening lungs for chronic GVHD

Evaluation

Patient-reported symptoms and signs

  • Difficulty breathing
  • Wheezing
  • Shortness of breath at rest and/or with exertion
  • Dry cough

Clinical examination

  • Chest auscultation
  • Pulse oximetry

Diagnostic testing

  • Pulmonary function testing (PFT)
  • Expiratory CT
  • Lung biopsy

Clinical manifestation

Clinical manifestation
Description

Bronchiolitis obliterans diagnosed using PFT

Obstructive lung defect. May include dyspenea on exertion, cough, or wheezing

Air trapping and bronchiectasis on chest CT*

Evidence of air trapping on expiratory CT, small airway thickening

Cryptogenic organizing pneumonia**

Inflammation of the bronchioles and surrounding tissue in the lungs


* Distinctive but insufficient alone to establish an unequivocal diagnosis of chronic GVHD without further testing or additional organ involvement.

** Rare, controversial, or non-specific features of chronic GVHD.