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CT Findings of Pneumonia After Lung Transplantation

Jannette Collins1, Nestor L. Müller2, Ella A. Kazerooni3 and Giuseppe Paciocco3

1 Department of Radiology, University of Wisconsin Hospital and Clinics, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI 53792-3252.
2 Department of Radiology, University of British Columbia Hospital and Health Sciences Centre, Vancouver Hospital and Health Sciences Centre, Heather Pavilion, 855 W. 12th Ave., Vancouver, B.C., Canada V5Z1M9.
3 Department of Radiology, University of Michigan Medical Center, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0326.



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  		Fig. 1. —Pseudomonas pneumonia in 33-year-old man who underwent bilateral lung transplantation for cystic fibrosis 3 years earlier. High-resolution CT scan shows areas of consolidation and ground-glass opacification in right middle lobe. Note "tree-in-bud" opacities (arrow) in periphery of right lower lobe.

 


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  		Fig. 2. —Gram-negative cocci pneumonia in 58-year-old woman who underwent right lung transplantation for pulmonary emphysema 4 months earlier. High-resolution CT scan shows focal ground-glass opacification (large arrow) in right middle lobe and "tree-in-bud" opacities (small arrows) in right lower lobe.

 


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  		Fig. 3. —Pseudomonas pneumonia in 29-year-old man who underwent bilateral lung transplantation for cystic fibrosis 1 year earlier. High-resolution CT scan shows multifocal areas of consolidation and ground-glass opacification in right middle, left upper, and both lower lobes. Bilateral pleural effusions extend into major fissures. Mild septal thickening (arrows) is seen in right middle lobe. Lower lobe bronchi are dilated.

 


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  		Fig. 4. —Staphylococcus aureus pneumonia in 40-year-old man who underwent bilateral lung transplantation for alpha1-antitrypsin deficiency 1 year earlier. High-resolution CT scan shows bilateral patchy areas of ground-glass opacification, consolidation, mild septal thickening, and bilateral small pleural effusions.

 


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  		Fig. 5A. —Pneumonia caused by legionella organisms in 32-year-old woman who underwent right lung transplantation for primary pulmonary hypertension 3 months earlier. High-resolution CT scans show diffuse extensive septal thickening and scattered ground-glass opacities in right upper, middle, and lower lobes. Only transplanted lung was involved.

 


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  		Fig. 5B. —Pneumonia caused by legionella organisms in 32-year-old woman who underwent right lung transplantation for primary pulmonary hypertension 3 months earlier. High-resolution CT scans show diffuse extensive septal thickening and scattered ground-glass opacities in right upper, middle, and lower lobes. Only transplanted lung was involved.

 


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  		Fig. 6. —Cytomegalovirus pneumonia in 57-year-old woman who underwent right lung transplantation for pulmonary emphysema 3 months earlier. CT scan (10-mm collimation) shows several well-circumscribed nodules of various size in right middle and lower lobes. Only transplanted lung was involved.

 


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  		Fig. 7. —Cytomegalovirus pneumonia in 57-year-old woman who underwent right lung transplantation for pulmonary emphysema 7 months earlier. High-resolution CT scan shows ground-glass opacification and extensive septal thickening in right upper and lower lobes. Only transplanted lung was involved.

 


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  		Fig. 8. —Aspergillus pneumonia in 47-year-old man who underwent left lung transplantation for pulmonary emphysema 1 year earlier. CT scan (10-mm collimation) shows well-circumscribed nodule in periphery of right upper lobe. Only native lung was involved.

 


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  		Fig. 9. —Aspergillus pneumonia in 48-year-old man who underwent right lung transplantation for Eisenmenger's syndrome 9 months earlier. CT scan (10-mm collimation) shows thick-walled cavitary mass in left lower lobe. Only native lung was involved.

 


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  		Fig. 10. —Aspergillus pneumonia in 33-year-old man who underwent bilateral lung transplantation for cystic fibrosis 3 years earlier. High-resolution CT scan shows patchy ground-glass opacification and consolidation in right lower lobe.

 


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  		Fig. 11. —Tuberculous pneumonia in 46-year-old woman who underwent bilateral lung transplantation for alpha1-antitrypsin deficiency 4 months earlier. High-resolution CT scan shows consolidation with air bronchograms in right lower lobe.

 


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  		Fig. 12A. —Mixed pneumonia in 47-year-old man who underwent bilateral lung transplantation for pulmonary emphysema 2 months earlier. High-resolution CT scans show patchy consolidation with air bronchograms and endobronchial debris (arrows) in right lower lobe. Sputum cultures grew Escherichia coli, Klebsiella, and Staphylococcus organisms; cytomegalovirus inclusion bodies were seen on transbronchial biopsy.

 


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  		Fig. 12B. —Mixed pneumonia in 47-year-old man who underwent bilateral lung transplantation for pulmonary emphysema 2 months earlier. High-resolution CT scans show patchy consolidation with air bronchograms and endobronchial debris (arrows) in right lower lobe. Sputum cultures grew Escherichia coli, Klebsiella, and Staphylococcus organisms; cytomegalovirus inclusion bodies were seen on transbronchial biopsy.

 

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