PMC5220135_01
CT of chest. (a) Day +325. (b) Day +364.
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PMC5220135_01_bmt2016197f1.jpg
fig1
Computed tomography (CT) of the chest showed rapidly progressive pulmonary infiltrates (Figure 1a). On day +364 he was discharged home off supplemental oxygen with significant clinical and radiographic improvement (Figure 1b).
Lung Biopsy with pathology of AFOP. (a) Arrow shows fibrin ball (b) HO-1, TNF-alpha and controls at 25x and 100x. Samples were deparaffinized and rehydrated. Ag retrieval was performed with 0.01 M citrate buffer (pH6.0) for 20  min. Then endogenous peroxidase was blocked with 3% H2O2/PBS for 5  min. Tissue samples were blocked in 1% normal swine serum (NSS) for 15  min, before incubation with primary antibodies for TNFalpha (clone 2C8, Novus Biologicals, Littleton, CO, USA) 670 mug/mL or HO-1 (clone HO-1-1, Enzo Life Sciences, Farmingdale, NY, USA) 20 mug/mL overnight in 1% normal swine serum/PBS. Next day, sections were stained with biotinylated secondary goat anti mouse Ab (1:1500, Millipore, Darmstadt, Germany) for 1 h followed by streptavidin/HRP solution (Vector laboratories, Burlingame, CA, USA) 1:200 for 45  min. Samples were stained with DAB chromogen (Dako, Carpinteria, CA, USA) and counterstained with Mayer's hematoxylin. Negative staining with isotype Ab run in parallel.
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PMC5220135_01_bmt2016197f2.jpg
fig2
On day +331 the pathology from the wedge resections showed Acute organizing fibrinous pneumonia (AFOP) (Figure 2a). TNF-alpha (Figure 2b).