CTICasesRhizopus Bronchitis at the Bronchial Anastomosis after Double Lung Transplant
[...]. Rhizopus Bronchitis at the Bronchial Anastomosis after Double Lung Transplant. CTICases. Published October 1, 2026. https://cticases.com/c/rk6gk
Imaging findings
Routine surveillance CT in a 55-year-old double lung transplant recipient shows new wall thickening of the right upper lobe bronchus and bronchus intermedius at the anastomosis, with surrounding soft tissue, and mild thickening at the middle and lower lobe bifurcation. The contralateral anastomosis has normal wall thickness for comparison. There is also a small pleural effusion. Bronchoscopy and biopsy showed Rhizopus bronchitis.
Key takeaways
Look closely at the bronchial anastomoses on every post-transplant CT, because new wall thickening there can be the only sign of serious disease. Rhizopus, a relative of Mucor, can infect the anastomosis and in this case responded well to treatment. The differential for anastomotic thickening or a mass includes Aspergillus infection, post-transplant lymphoproliferative disorder, and ischemic airway injury.
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