Delayed pneumothorax after bronchoscopy in a lung transplant patient

Lung transplant patients commonly undergo transbronchial biopsy to evaluate for rejection. Post-biopsy radiographs are used to exclude pneumothorax, one of the most common major complications. We report a lung transplant patient who developed a pneumothorax 5 months after transbronchial biopsy, with multiple intervening chest computed tomograms documenting that the pneumothorax developed from the biopsy site. This case illustrates that in transplant patients transbronchial biopsy can evolve to pneumothorax several months later, despite normal post-biopsy radiographs.