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Figure 13a. Mycobacterium infection in a patient with bilateral lung transplants for end-stage pulmonary fibrosis. (a, b) Axial chest CT images, obtained more than 12 weeks after lung transplantation, demonstrate tree-in-bud nodularity and multiple ground-glass opacities (arrows in a) in the middle and lower lobes of the right lung and consolidation (arrow in b) in the lower lobe. Subsequent bronchoalveolar lavage cultures from the right middle and lower lobes were positive for nontuberculous Mycobacterium. (c) Medium-power photomicrograph (original magnification, x100; H–E stain) shows granulomatous inflammation with giant cells obliterating a bronchiole (arrow). Note the presence of organizing pneumonia with intraalveolar fibrous plugs (*).
