Graft-versus-host disease chest x ray

A chest X-ray can be done to evaluate for pneumonitis, which can be a manifestation of pulmonary GvHD. A variety of radiographic features can be seen.

A chest X-ray can be done to assess for immune attack in the lungs, such as pneumonitis. Pneumonitis is a less common GvHD manifestation compared to rash, liver dysfunction, and diarrhea. However, pneumonitis has been known to occur. Pneumonitis presents radiographically as a nodular or interstitial pattern. There can be inflammation in the peri-bronchiolar tissue, resulting in variable areas of hyperdensity and hypodensity on the chest X-ray. Ground glass appearance and consolidative opacities can also be seen.^[1] CT scan of the chest can better diagnose pneumonitis.

A chest X-ray is also an important diagnostic tool in the evaluation of other stem cell transplant-related conditions, such as pneumonia, volume overload, transfusion-related acute lung injury (TRALI). Chest X-ray can help differentiate pulmonary GvHD from these conditions. Volume overload and transfusion-related acute lung injury (TRALI) will show blunting of the costophrenic angles and pulmonary vascular engorgement, reflecting excess fluid in the lungs.

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