Dyspnea in a Transplant Recipient With Pulmonary Nodules

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Presentation transcript:

Dyspnea in a Transplant Recipient With Pulmonary Nodules Wen Yee Chay, MD, Alvin Penafiel, MD, Jagadesan Raghuram, MD, Khoon Leong Chuah, MD, Chian Min Loo, MD, FCCP, Pyng Lee, MD, FCCP CHEST Volume 135, Issue 3, Pages 860-865 (March 2009) DOI: 10.1378/chest.08-0857 Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 1 Chest radiograph showing hyperinflated lungs with bilateral basal nodular opacities. CHEST 2009 135, 860-865DOI: (10.1378/chest.08-0857) Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 2 CT scan showing an endobronchial mass obstructing the left mainstem bronchus (black arrowhead) and well-defined nodules of different sizes randomly distributed throughout the lungs (white arrows). CHEST 2009 135, 860-865DOI: (10.1378/chest.08-0857) Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 3 Bronchoscopic image of near total obstruction of the left mainstem bronchus by an endobronchial mass. CHEST 2009 135, 860-865DOI: (10.1378/chest.08-0857) Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 4 A higher magnification image showing spindle cells with eosinophilic cytoplasm and a surface-attenuated epithelium in the right field (hematoxylin-eosin, original ×200). CHEST 2009 135, 860-865DOI: (10.1378/chest.08-0857) Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 5 A high-power view showing tumor cells decorated by antibodies against caldesmon, a smooth muscle marker (avidin biotin complex staining method, original ×400). CHEST 2009 135, 860-865DOI: (10.1378/chest.08-0857) Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 6 Nuclear positive labeling by probes against EBV-encoded RNA (in situ hybridization, original ×200). CHEST 2009 135, 860-865DOI: (10.1378/chest.08-0857) Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 7 A CT scan showing a patent left mainstem bronchus, and resolution and a decrease in the size of pulmonary nodules. CHEST 2009 135, 860-865DOI: (10.1378/chest.08-0857) Copyright © 2009 The American College of Chest Physicians Terms and Conditions