An Unusual Case of Pulmonary Embolism

A 33-year-old woman had dyspnea for six months, with intermittent fever. She was admitted to the hospital with worsening dyspnea, hypoxia, and patchy bilateral pulmonary consolidations. Computed tomography showed large, central pulmonary filling defects (Panel A, arrows). The patient was treated with anticoagulation and antibiotics. Her condition deteriorated, and she received an intravenous thrombolytic agent, with no improvement. She then underwent urgent pulmonary thromboendarterectomy, during which she was found to have pale, lobulated tissue completely filling both pulmonary arteries. A complete resection was performed, but a reperfusion lung injury developed, and the patient died. Histologic examination of the resected specimen . . .