PMC9135379_01
Chest CT. A - axial plane - B - coronal plane -showing bilateral diffuse mixed interstitial and alveolar opacities, predominantly in the upper lobe.
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The chest CT showed bilateral alveolar and interstitial opacities involving both the upper and lower lobes (Figure 1), confirmed by a high-resolution computerized tomography.
Photomicrographs of the lung. A (100x) and B (200x) - H&E stain shows alveoli completely filled with amorphous eosinophilic material. A few scattered macrophages, as well as cholesterol clefts, are present within the eosinophilic material. There is a minimal interstitial inflammatory cell infiltrate, there are no granulomas and no fibrosis. Note that the basic alveolar architecture is preserved. C (200x) and D (100x) - Fragments of Lung Parenchyma showing intra-alveolar filling with coarsely granular eosinophilic material that is strongly positive on PAS and d-PAS.
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No microorganisms were identified on other stains for acid-fast bacilli or for fungi (Figure 2).
Chest CT. A - axial plane, B - Coronal plane; showing a marked decrease of the patchy ground-glass attenuation and interstitial thickening in both lungs.
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Her follow-up chest CT revealed near-complete clearance of the opacities four months after her bone marrow transplant (Figure 3).