[Graft-versus-host Disease Detected Early Due to Repeated Pneumothorax after Bone Marrow Transplantation]

A 15-year-old boy who presented recurrent bilateral pneumothoraces after allogenic bone marrow transplantation for the treatment of myelodysplastic syndrome is presented. We performed bulla resection under the thoracoscopic surgery for three times. Pathological examination revealed irregular fibrous thickening of the visceral pleura and alveolar fibrosis, consistent with a diagnosis of pleuroparenchymal fibroelastosis (PPFE). Also the findings of bronchiolitis obliterans (BO) was noted and chronic graftversus-host disease( GVHD) was strongly suggested. Twenty-five months after the operation, bilateral living-donor lobar lung transplantation was performed and the diagnosis of GVHD was established.