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Presented by Peter Illei, M.D. and prepared by ChanJuan Shi, M.D., Ph.D.
Case 3: 64 y.o. white female patient s/p bilateral lung transplant for COPD.
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Question 1 of 1
1. Question
Week 353: Case 3
64 y.o. white female patient s/p bilateral lung transplant for COPD. Prior routine follow up biopsies showed no evidence of rejection. She developed increasing malaise, fatigue, subjective fevers, and dyspnea over several days prior to admission.images/illei060908-3a.jpg
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images/illei060908-3d.jpgCorrect
Answer: CMV pneumonia
Histology: none provided
Discussion: Sections show alveolar lung parenchyma with interstitial widening and scattered enlarged atypical pneumocytes with eosinophilic intranuclear and Cytoplasmic inclusions. Immunohistochemistry for CMV is positive in the inclusions and confirms the diagnosis. The peripheral vasculature is clean and there is no evidence of acute cellular rejection (ISHLT A0BX). The patient serum PCR was also positive for CMV further supporting the diagnosis.
Incorrect
Answer: CMV pneumonia
Histology: none provided
Discussion: Sections show alveolar lung parenchyma with interstitial widening and scattered enlarged atypical pneumocytes with eosinophilic intranuclear and Cytoplasmic inclusions. Immunohistochemistry for CMV is positive in the inclusions and confirms the diagnosis. The peripheral vasculature is clean and there is no evidence of acute cellular rejection (ISHLT A0BX). The patient serum PCR was also positive for CMV further supporting the diagnosis.
