The puzzling coexistence of different histological changes in the same transplanted lung

Large fragments of a transplanted lung from living lung recipients are rarely available. The case presented is that of a patient who underwent lingulectomy after a gunshot trauma. We describe the patchy panel of histological findings encountered in the resected specimen, ranging from normal lung to zones of acute and chronic rejection. Such contrasting findings have already been described, but should prompt us to exercise caution when interpreting histological results of routine transbronchial biopsies.