Fig. 5
From: Imaging indications and findings in evaluation of lung transplant graft dysfunction and rejection
A 60-year-old male with rheumatoid arthritis–related usual interstitial pneumonia status post right lung transplant presented with shortness of breath. CT-PE protocol was performed. Axial images using soft tissue (a and b) and lung (c and d) windows show infiltrative right hilar and perihilar soft tissue density (arrows), peribronchovascular interstitial thickening, interlobular septal thickening, and ground-glass opacities within the transplanted right lung. Advanced fibrosis with exuberant honeycombing is noted in the native left lung. These findings raised concern for post-transplant lymphoproliferative disorder. Pathology and EBV PCR were negative. Flow cytometry was positive for donor specific antibody to DQ2. These findings were suggestive of antibody-mediated rejection