Talk:Heart transplant pathology - Revision history

Michael: /* Final diagnosis */ sm fix.

2011-03-24T14:12:46Z

Final diagnosis: sm fix.

← Older revision		Revision as of 14:12, 24 March 2011
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	The sections show endomyocardium that is of sufficient size to evaluate for acute cellular rejection activity and has multiple myocardial scars. There are focal, sparse lymphocytic infiltrates adjacent to the scar tissue, which is consistent with old biopsy sites. Most blood vessels appear histomorphologically normal; however, there is focal, mild vascular swelling with perivascular edema and lymphocyte margination. There is no evidence of post transplant lymphoproliferative disease.		The sections show endomyocardium that is of sufficient size to evaluate for acute cellular rejection activity and has multiple myocardial scars. There are focal, sparse lymphocytic infiltrates adjacent to the scar tissue, which is consistent with old biopsy sites. Most blood vessels appear histomorphologically normal; however, there is focal, mild vascular swelling with perivascular edema and lymphocyte margination. There is no evidence of post transplant lymphoproliferative disease.

	==Final diagnosis==		===Final diagnosis===
	Heart allograft, endomyocardial biopsies x 7 - ISHLT Grade 1R, acute cellular rejection, focal, mild.		Heart allograft, endomyocardial biopsies x 7 - ISHLT Grade 1R, acute cellular rejection, focal, mild.

Michael: /* Final diagnosis */

2011-03-22T20:30:05Z

Final diagnosis

← Older revision		Revision as of 20:30, 22 March 2011
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	The sections show endomyocardium that is of sufficient size to evaluate for acute cellular rejection activity. There are focal, lymphocytic infiltrates adjacent to blood vessels with reactive endothelium. No myocyte necrosis is identified. No perivascular edema is evident. The myocardium has multiple scars, shows reactive hypertrophy with nuclear enlargement, and has lipofuscin deposits. There is fatty replacement of the myocardium involving up to 15% of the biopsy. Focally, myocytes have clear cytoplasmic vacuoles (lipid accumulation). There is no evidence of a post transplant lymphoproliferative disease.		The sections show endomyocardium that is of sufficient size to evaluate for acute cellular rejection activity. There are focal, lymphocytic infiltrates adjacent to blood vessels with reactive endothelium. No myocyte necrosis is identified. No perivascular edema is evident. The myocardium has multiple scars, shows reactive hypertrophy with nuclear enlargement, and has lipofuscin deposits. There is fatty replacement of the myocardium involving up to 15% of the biopsy. Focally, myocytes have clear cytoplasmic vacuoles (lipid accumulation). There is no evidence of a post transplant lymphoproliferative disease.

	==Final diagnosis==		===Final diagnosis===
	Heart allograft, endomyocardial biopsies x 5 - ISHLT Grade 1R, mild acute cellular rejection, focal, with:<br>		Heart allograft, endomyocardial biopsies x 5 - ISHLT Grade 1R, mild acute cellular rejection, focal, with:<br>
	:i) AMR - 0 (by ordinary light microscopy) <br>		:i) AMR - 0 (by ordinary light microscopy) <br>
	:ii) endomyocardial fibrosis, focal <br>		:ii) endomyocardial fibrosis, focal <br>
			:iii) fatty replacement of myocardium and myocyte vacuolization

	== Biopsy - moderate ==		== Biopsy - moderate ==

Michael: /* Biopsy - mild cellular 2 */ fxi

2011-03-22T20:29:38Z

Biopsy - mild cellular 2: fxi

← Older revision		Revision as of 20:29, 22 March 2011
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	==Biopsy - mild cellular 2==		==Biopsy - mild cellular 2==
	===Microscopic===		===Microscopic===
	The sections show endomyocardium that is of sufficient size to evaluate for acute cellular rejection activity. There are focal, lymphocytic infiltrates adjacent to blood vessels with reactive endothelium~~, mild perivascular edema and lymphocyte margination~~. No myocyte necrosis is identified. The myocardium has multiple scars, shows reactive hypertrophy with nuclear enlargement, and has lipofuscin deposits. There is no evidence of a post transplant lymphoproliferative disease.		The sections show endomyocardium that is of sufficient size to evaluate for acute cellular rejection activity. There are focal, lymphocytic infiltrates adjacent to blood vessels with reactive endothelium. No myocyte necrosis is identified. No perivascular edema is evident. The myocardium has multiple scars, shows reactive hypertrophy with nuclear enlargement, and has lipofuscin deposits. There is fatty replacement of the myocardium involving up to 15% of the biopsy. Focally, myocytes have clear cytoplasmic vacuoles (lipid accumulation). There is no evidence of a post transplant lymphoproliferative disease.

	==Final diagnosis==		==Final diagnosis==

Michael: more

2011-03-22T16:31:03Z

← Older revision		Revision as of 16:31, 22 March 2011
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	==Biopsy - mild ~~acellular~~==		== Biopsy - benign ==

			===Microscopic===
			The biopsy sample is adequate to pathologically evaluate acute cellular rejection activity. There is microcopic focal endomyocardial fibrosis which may represent the site of a previous biopsy. One small lymphocytic infiltrate is seen superficially (Quilty effect). Inflammation of the myocardium is not appreciated. Edema of the myocardium is not appreciated. Myocardial vessels are unremarkable.

			===Final diagnosis===
			Heart allograft, endomyocardial biopsies x 5 - ISHLT Grade 0, no evidence of acute cellular rejection, with:<br>
			:i) AMR - 0 (by ordinary light microscopy) <br>
			:ii) endomyocardial fibrosis, focal <br>
			:iii) endocardial lymphocytic infiltrate (Quilty effect), small

			==Biopsy - mild cellular 1==
	===Microscopic===		===Microscopic===
	The sections show endomyocardium that is of sufficient size to evaluate for acute cellular rejection activity and has multiple myocardial scars. There are focal, sparse lymphocytic infiltrates adjacent to the scar tissue, which is consistent with old biopsy sites. Most blood vessels appear histomorphologically normal; however, there is focal, mild vascular swelling with perivascular edema and lymphocyte margination. There is no evidence of post transplant lymphoproliferative disease.		The sections show endomyocardium that is of sufficient size to evaluate for acute cellular rejection activity and has multiple myocardial scars. There are focal, sparse lymphocytic infiltrates adjacent to the scar tissue, which is consistent with old biopsy sites. Most blood vessels appear histomorphologically normal; however, there is focal, mild vascular swelling with perivascular edema and lymphocyte margination. There is no evidence of post transplant lymphoproliferative disease.
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	Heart allograft, endomyocardial biopsies x 7 - ISHLT Grade 1R, acute cellular rejection, focal, mild.		Heart allograft, endomyocardial biopsies x 7 - ISHLT Grade 1R, acute cellular rejection, focal, mild.

	== Biopsy - ~~benign~~ ==		==Biopsy - mild cellular 2==

	===Microscopic===		===Microscopic===
	The ~~biopsy sample~~ is ~~adequate~~ to ~~pathologically~~ evaluate acute cellular rejection activity. There ~~is microcopic~~ focal ~~endomyocardial fibrosis which may represent the site of a previous biopsy~~. ~~One small lymphocytic infiltrate~~ is ~~seen superficially (Quilty effect)~~. ~~Inflammation of the~~ myocardium ~~is not appreciated~~. ~~Edema~~ of ~~the myocardium is not appreciated~~. ~~Myocardial vessels are unremarkable.~~		The sections show endomyocardium that is of sufficient size to evaluate for acute cellular rejection activity. There are focal, lymphocytic infiltrates adjacent to blood vessels with reactive endothelium, mild perivascular edema and lymphocyte margination. No myocyte necrosis is identified. The myocardium has multiple scars, shows reactive hypertrophy with nuclear enlargement, and has lipofuscin deposits. There is no evidence of a post transplant lymphoproliferative disease.

	===Final diagnosis===		==Final diagnosis==
	Heart allograft, endomyocardial biopsies x 5 - ISHLT Grade 0, ~~no evidence of~~ acute cellular rejection, with:<br>		Heart allograft, endomyocardial biopsies x 5 - ISHLT Grade 1R, mild acute cellular rejection, focal, with:<br>
	:i) AMR - 0 (by ordinary light microscopy) <br>		:i) AMR - 0 (by ordinary light microscopy) <br>
	:ii) endomyocardial fibrosis, focal <br>		:ii) endomyocardial fibrosis, focal <br>
	~~:iii) endocardial lymphocytic infiltrate (Quilty effect), small~~

	== Biopsy - moderate ==		== Biopsy - moderate ==

	===Microscopic description===		===Microscopic description===
	Multiple serial sections show that there is one large, and two smaller regions of perivascular, deep myocardial, lymphocyte-predominant inflammation. The large lesion is associated with, reactive endothelium, edema of the myocardium, cytoplasmic myocyte eosinophilia and moderate reactive nuclear enlargement. The myocardial vessels distant from the lymphocytic infiltrates, focally, show lymphocyte-margination without endothelial changes and without significant edema.		Multiple serial sections show that there is one large, and two smaller regions of perivascular, deep myocardial, lymphocyte-predominant inflammation. The large lesion is associated with, reactive endothelium, edema of the myocardium, cytoplasmic myocyte eosinophilia and moderate reactive nuclear enlargement. The myocardial vessels distant from the lymphocytic infiltrates, focally, show lymphocyte-margination without endothelial changes and without significant edema.

Michael: /* Biopsy - moderate */ new section

2011-03-09T20:58:04Z

Biopsy - moderate: new section

← Older revision		Revision as of 20:58, 9 March 2011
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	:ii) endomyocardial fibrosis, focal <br>		:ii) endomyocardial fibrosis, focal <br>
	:iii) endocardial lymphocytic infiltrate (Quilty effect), small		:iii) endocardial lymphocytic infiltrate (Quilty effect), small

			== Biopsy - moderate ==

			===Microscopic description===
			Multiple serial sections show that there is one large, and two smaller regions of perivascular, deep myocardial, lymphocyte-predominant inflammation. The large lesion is associated with, reactive endothelium, edema of the myocardium, cytoplasmic myocyte eosinophilia and moderate reactive nuclear enlargement. The myocardial vessels distant from the lymphocytic infiltrates, focally, show lymphocyte-margination without endothelial changes and without significant edema.

			The biopsy sample is adequate to pathologically evaluate acute cellular rejection activity. There is no significant endomyocardial fibrosis. Several lymphocytic infiltrates are seen superficially (Quilty effect).

			===Final diagnosis===
			Heart allograft, endomyocardial biopsies x 4 - ISHLT Grade 1-2, mild-to-moderate acute cellular rejection, with:
			<br> i) antibody-mediated rejection (AMR) - 0 (by ordinary light microscopy)
			<br> ii) no significant endomyocardial fibrosis
			<br> iii) Quilty effect (endocardial lymphocytic infiltrate), several

Michael: /* Biopsy - benign */

2011-02-09T21:54:43Z

Biopsy - benign

← Older revision		Revision as of 21:54, 9 February 2011
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	===Final diagnosis===		===Final diagnosis===
	Heart allograft, endomyocardial biopsies x 5 - ISHLT Grade 0, no evidence of acute cellular rejection, with:		Heart allograft, endomyocardial biopsies x 5 - ISHLT Grade 0, no evidence of acute cellular rejection, with:<br>
	i) AMR - 0 (by ordinary light microscopy)		:i) AMR - 0 (by ordinary light microscopy) <br>
	ii) endomyocardial fibrosis, focal		:ii) endomyocardial fibrosis, focal <br>
	iii) endocardial lymphocytic infiltrate (Quilty effect), small		:iii) endocardial lymphocytic infiltrate (Quilty effect), small

Michael: /* Biopsy - benign */ new section

2011-02-09T21:53:52Z

Biopsy - benign: new section

← Older revision		Revision as of 21:53, 9 February 2011
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	==Final diagnosis==		==Final diagnosis==
	Heart allograft, endomyocardial biopsies x 7 - ISHLT Grade 1R, acute cellular rejection, focal, mild.		Heart allograft, endomyocardial biopsies x 7 - ISHLT Grade 1R, acute cellular rejection, focal, mild.

			== Biopsy - benign ==

			===Microscopic===
			The biopsy sample is adequate to pathologically evaluate acute cellular rejection activity. There is microcopic focal endomyocardial fibrosis which may represent the site of a previous biopsy. One small lymphocytic infiltrate is seen superficially (Quilty effect). Inflammation of the myocardium is not appreciated. Edema of the myocardium is not appreciated. Myocardial vessels are unremarkable.

			===Final diagnosis===
			Heart allograft, endomyocardial biopsies x 5 - ISHLT Grade 0, no evidence of acute cellular rejection, with:
			i) AMR - 0 (by ordinary light microscopy)
			ii) endomyocardial fibrosis, focal
			iii) endocardial lymphocytic infiltrate (Quilty effect), small

Michael at 20:51, 13 January 2011

2011-01-13T20:51:44Z

← Older revision		Revision as of 20:51, 13 January 2011
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	==Biopsy - mild acellular==		==Biopsy - mild acellular==
	===Microscopic===		===Microscopic===
	The sections show ~~a well-sampled~~ endomyocardium ~~with~~ multiple myocardial scars. There are focal, sparse lymphocytic infiltrates adjacent to the scar tissue, which is consistent with old biopsy sites. Most blood vessels appear histomorphologically normal; however, there is focal, mild vascular swelling with lymphocyte margination.		The sections show endomyocardium that is of sufficient size to evaluate for acute cellular rejection activity and has multiple myocardial scars. There are focal, sparse lymphocytic infiltrates adjacent to the scar tissue, which is consistent with old biopsy sites. Most blood vessels appear histomorphologically normal; however, there is focal, mild vascular swelling with perivascular edema and lymphocyte margination. There is no evidence of post transplant lymphoproliferative disease.

	==Final diagnosis==		==Final diagnosis==
	Heart allograft, endomyocardial biopsies x 7 - ISHLT Grade 1R, acute cellular rejection, focal, mild.		Heart allograft, endomyocardial biopsies x 7 - ISHLT Grade 1R, acute cellular rejection, focal, mild.

Michael: /* Biopsy - mild acellular */ sm fix

2011-01-13T20:42:08Z

Biopsy - mild acellular: sm fix

← Older revision		Revision as of 20:42, 13 January 2011
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	==Biopsy - mild acellular==		==Biopsy - mild acellular==
	===Microscopic====		===Microscopic===
	The sections show a well-sampled endomyocardium with multiple myocardial scars. There are focal, sparse lymphocytic infiltrates adjacent to the scar tissue, which is consistent with old biopsy sites. Most blood vessels appear histomorphologically normal; however, there is focal, mild vascular swelling with lymphocyte margination.		The sections show a well-sampled endomyocardium with multiple myocardial scars. There are focal, sparse lymphocytic infiltrates adjacent to the scar tissue, which is consistent with old biopsy sites. Most blood vessels appear histomorphologically normal; however, there is focal, mild vascular swelling with lymphocyte margination.

	==Final diagnosis==		==Final diagnosis==
	Heart allograft, endomyocardial biopsies x 7 - ISHLT Grade 1R, acute cellular rejection, focal, mild.		Heart allograft, endomyocardial biopsies x 7 - ISHLT Grade 1R, acute cellular rejection, focal, mild.

Michael: create

2011-01-13T20:41:58Z

create

New page

==Biopsy - mild acellular==
===Microscopic====
The sections show a well-sampled endomyocardium with multiple myocardial scars. There are focal, sparse lymphocytic infiltrates adjacent to the scar tissue, which is consistent with old biopsy sites. Most blood vessels appear histomorphologically normal; however, there is focal, mild vascular swelling with lymphocyte margination.

==Final diagnosis==
Heart allograft, endomyocardial biopsies x 7 - ISHLT Grade 1R, acute cellular rejection, focal, mild.