Vinod Khanijow¹, D Milne², S McCarthy^1
1Northern Forensic Pathology Service, Auckland City Hospital, Auckland, New Zealand; ²Department of Radiology, Auckland City Hospital, Auckland, New Zealand.

Transfusion-related acute lung injury (TRALI) is a well-documented and serious complication of blood transfusion that remains a significant cause of transfusion-related morbidity and mortality. This case report presents the post-mortem findings, including both computed tomography (CT) and autopsy examinations, of an 87-year-old male who developed TRALI following multiple blood transfusions for anaemia secondary to a gastrointestinal haemorrhage. The patient exhibited a clinical course, classical for TRALI. Post-mortem CT revealed interstitial pulmonary oedema while histology showed intravascular neutrophil aggregates without signs of pneumonia or anaphylaxis. This report underscores the diagnostic challenge of TRALI in combination with imaging and histopathological findings.