Figure 13b.  Acute allograft rejection in a 62-year-old man who developed hypotension and congestive heart failure 10 weeks after cardiac transplantation for dilated cardiomyopathy. (a) AP upright chest radiograph shows an enlarged cardiac silhouette, pulmonary edema, and bilateral pleural effusions. The postoperative image also reveals sternal wires, endotracheal tube, nasogastric tube, right subclavian venous catheter, and pulmonary artery catheter in the distal right lower lobe interlobar pulmonary artery. (b) High-power photomicrograph (original magnification, x400; hematoxylin-eosin stain) shows diffuse lymphocytic infiltration of the myocardium with patchy myocyte necrosis.