PULMONARY COMPLICATIONS IN PATIENTS WITH HEMATOLOGIC DISORDERS

The lung is prone to develop various complications in patients with hematological disorders due to its structural and functional properties. Genetic predisposition, although probably involved, is not yet well understood. The secondary involvement of lung parenchyma by a lymphoproliferative malignancy is not an unusual event. Furthermore, the advances in treatment options such as hematopoietic stem cell transplantation, radiation therapy, newer polychemotherapeutic regimens even including the most recent drugs, have significantly widened the spectrum of non-neoplastic complications that can rise up in these patients. Infections, drug/radiation-induced toxicity, and graft versus host disease account by now for most pulmonary problems in hematologic patients and represent a diagnostic challenge for the clinician. A specific diagnosis is, however, important for prompt initiation of the correct therapy. High resolution computed tomography followed by bronchoalveolar lavage and/or transbronchial lung biopsy have proved to be the most helpful diagnostic tools within the multidisciplinary approach to these disorders. The aim of this review is to highlight the clinico-pathologic spectrum of lung diseases which can occur in the setting of hematologic neoplasms, pointing up the clinical approach with the different diagnostic tools avaible. Pulmonary amyloidosis and lung complications in hemoglobinopathies, erythrocyte and coagulation disorders will not be examinated.