PMC3177594_01
Chest radiographs. (A) Onset of the first transfusion-related acute lung injury episode on hospital day 3. (B) At the initiation of mechanical ventilation on day 9. (C) A clear chest radiograph on day 23. (D) Onset of the second first transfusion-related acute lung injury episode on hospital day 34.
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A chest radiograph showed bilateral diffuse pulmonary infiltrates without cardiomegaly (Figure 1A). Methylprednisolone sodium succinate was administered for pulmonary edema, but pulmonary infiltrates and hypoxemia continued to worsen (Figure 1B). On day 23, chest radiography showed a significant improvement in pulmonary shadows (Figure 1C). Bilateral pulmonary infiltrates were again observed on a chest radiograph (Figure 1D).
Pathological findings. (A and B) Findings of histological examination of the lung: (A) result of hematoxylin and eosin staining revealed diffuse alveolar damage with hyaline membrane formation (x200), (B) result of immunostaining for CD41 demonstrated the sequestration of platelets in the lung (x200). (C) Positive control of immunostaining for CD41 (normal bone marrow) (x200).
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An autopsy was performed, and the pathological findings of the lungs indicated diffuse alveolar damage with hyaline membrane formation (Figure 2A). The results clearly demonstrated the sequestration of platelets in the patient's lung (Figure 2B).