Talk:Heart transplant pathology: Difference between revisions
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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. | ||
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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 == | ||