Opportunistic pathogens account for the majority of pulmonary infections requiring invasive diagnosis and tend to manifest at predictable times in the course of events following recovery from bone marrow transplantation. Cytomegalovirus, the most common pathogen, causes a spectrum of radiographic findings that includes normal findings. Occurrence of a pulmonary infection is associated with an increased mortality rate.

Our data showed suboptimal use of the Wells criteria and subjective overestimation of the probability of PE before ordering of CTA. Although a definitive acceptable PE positivity rate for CTA has not been established, the 10% yield represents overuse of CTA as a screening rather than a diagnostic examination.

Summary:We describe the rare occurrence of a granulomatous pneumonitis seen in a patient following allogeneic bone marrow transplantation. Interestingly sarcoidosis was diagnosed in the marrow donor less than a year after donating his bone marrow. Bone Marrow Transplantation (2001) 28, 627-630. Keywords: alveolitis; extrinsic allergic; sarcoidosis; bone marrow transplantation; granuloma Case report, recipientA 37-year-old white female presented with a lump in her neck in November 1996. Biopsy revealed a large B cell lymphoma. Chest and abdominal CT scans showed axillary, mediastinal and retroperitoneal adenopathy and a solitary left pulmonary nodule. Bone marrow examination was negative for lymphomatous involvement. She received six cycles of chemotherapy comprising cyclophosphamide, adriamycin (total dose 300 mg/m 2 ), procarbazine and prednisone. Follow-up evaluations showed progression of disease with an increase in axillary adenopathy and the appearance of bilateral pulmonary nodules. She was then given salvage chemotherapy with etoposide, methylprednisolone, cisplatinum and cytarabine.She underwent an HLA-identical bone marrow transplant from her brother in June 1997. The HLA type was A (1,26); B(8,49); Bw(4,6); Cw (7,-); DR␤1‫;11030ء‬ DR␤1‫.2031ء‬ The conditioning regimen consisted of VP-16, 60 mg/kg and TBI dosing of 225 cGy for 6 days. She received methotrexate and cyclosporine for graft-versushost disease (GVHD) prophylaxis and engrafted on day 13 following the transplantation. She developed a skin rash 140 days following the transplant and was treated for cutaneous GVHD with prednisone and cyclosporine that were tapered off in July 1998. A chest X-ray in June 1998 showed a small ill-defined opacity in the right lower

During inspiration, there is a variable increase in unopacified venous blood from the IVC, briefly diluting the contrast column entering from the SVC. This interruption is common, though usually mild in severity. However, a short severe interruption of vascular opacification can lead to misinterpretation as a pulmonary embolus or contribute to an indeterminate examination.

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