Difference between revisions of "Heart transplant pathology"

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'''[[Heart]] transplant pathology''' is a niche in [[cardiac pathology]].
'''[[Heart]] transplant pathology''' is a niche in [[cardiac pathology]].
It comes in different flavours:
*Acute vascular rejection.
*Cellular rejection.
*Chronic rejection.
==Biopsy site reaction==
===General===
*Can be confused for rejection.
===Microscopic===
Features:
*Hemosiderin-laden macrophages.
*+/-Fibrosis/myofibre loss-replacement.
*+/-Scant inflammatory infiltration.
Image: [http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970592-7&figureId=fig6 Biopsy site (pathconsultddx.com)].
==Acute rejection==
===Microscopic===
Features:<ref>URL: [http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970592-7&figureId=fig4 http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970592-7&figureId=fig4]. Accessed on: 7 January 2011.</ref>
*Edema.
*Dilated small vessels.
*Scant inflammatory infiltrate.
Image:
*[http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970592-7&figureId=fig4 Acute rejection (pathconsultddx.com)].


==Cellular rejection==
==Cellular rejection==
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==Chronic rejection==
===Microscopic===
Features:<ref>URL: [http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970592-7&figureId=fig5 http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970592-7&figureId=fig5]. Accessed on: 7 January 2011.</ref>
*Concentric intimal thickening.
*Preservation of internal elastic lamina.
Image: [http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970592-7&figureId=fig5 Chronic rejection (pathconsultddx.com)].
Notes:
*Vague similar to atherosclerosis.


==See also==
==See also==
*[[Heart]].
*[[Heart]].
*[[Lung transplant pathology]].


==References==
==References==

Revision as of 20:10, 7 January 2011

Heart transplant pathology is a niche in cardiac pathology.

It comes in different flavours:

  • Acute vascular rejection.
  • Cellular rejection.
  • Chronic rejection.

Biopsy site reaction

General

  • Can be confused for rejection.

Microscopic

Features:

  • Hemosiderin-laden macrophages.
  • +/-Fibrosis/myofibre loss-replacement.
  • +/-Scant inflammatory infiltration.

Image: Biopsy site (pathconsultddx.com).

Acute rejection

Microscopic

Features:[1]

  • Edema.
  • Dilated small vessels.
  • Scant inflammatory infiltrate.

Image:

Cellular rejection

Grading scheme 2004/1990:[2]

Grade 2004 Grade 1990 Description Details Image
0R 0 normal no extravascular monocytes
1R 1A infiltrate, myocyte damage scant interstitial infiltrate (lymphoplasmic), scant damage mild
1R 1B infiltrate, myocyte damage diffuse interstitial infiltrate (lymphoplasmic), focal damage
1R 2 infiltrate, myocyte damage diffuse interstitial infiltrate (lymphoplasmic), obvious damage
2R 3A space-occupying lesion diffuse interstitial infiltrate displaces parenchyma (lymphoplasmic), obvious damage mod., mod. resolving
3R 3B disruption of normal arch. diffuse interstitial infiltrate disrupts parenchyma (lymphoplasmic & PMNs), obvious damage
3R 4 disruption of normal arch. diffuse interstitial infiltrate disrupts parenchyma (lymphoplasmic & PMNs), fibre loss

Chronic rejection

Microscopic

Features:[3]

  • Concentric intimal thickening.
  • Preservation of internal elastic lamina.

Image: Chronic rejection (pathconsultddx.com).

Notes:

  • Vague similar to atherosclerosis.

See also

References

  1. URL: http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970592-7&figureId=fig4. Accessed on: 7 January 2011.
  2. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 136. ISBN 978-0781765275.
  3. URL: http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970592-7&figureId=fig5. Accessed on: 7 January 2011.

External links