PMC7598439_01
Recipient's chest CT scan pre-transplantation.
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The patient suffered from Pseudomonas aeruginosa and Mycobacterium kansasii chronic colonization that caused frequent acute exacerbations (Fig. 1).
Post-transplantation chest x-rays.. POD: postoperative day.
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The daily chest radiographs showed unchanged findings: ill-defined bilateral confluent diffuse airspace opacities were initially interpreted as ischemia-reperfusion damage, but the progressive increase proved otherwise (Fig. 2).
Chest CT scan on POD10.
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This hypothesis was reinforced by the results of the total-body computed tomography (CT) performed on POD 10 (Fig. 3).
Lung core-biopsy stained glass slides.. Acute alveolar damage with hyaline membrane deposition in the alveolar lumina, associated with patchy interstitial acute e chronic infiltrate, showing plurifocal infiltration of the bronchiolar wall and epithelium and plurifocal venulitis. C4d immunohistochemical staining showed a diffuse, weak staining of the capillary walls.
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The pathology revealed a moderate/severe acute rejection as well as the presence of C4d staining (Fig. 4).
Clinical course of the patient.. BAL: bronchoalveolar lavage; CT: computed tomography; FNAB: fine needle aspiration biopsy.
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Fig. 5 summarizes the clinical course of the patient.