Difference between revisions of "Talk:Lung transplant pathology"

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==Minimal rejection==
==Minimal rejection==
===Microscopic description===
===Microscopic description===
The specimen has four pieces of alveolated lung tissue. This is borderline adequate for the assessment of acute cellular rejection. Some medium-sized airways and bronchial wall is included. There are several small alveolar septal aggregates of small lymphocytes. These minimally expand the alveolar septa. One large lymphocyte aggregate, adjacent to anthrocotic pigment, is present and appears to be associated with a blood vessel.  There are no eosinophils or neutrophils. There is no epithelial damage. There are scattered hemosidern-laden macrophages. There is no suggestion of bronchiolitis obliterans or organizing pneumonia is seen with elastic trichrome stain. Special stains for fungus (PAS with and without diastase, GMS) and Pneumocystis (GMS) are negative. Immunohistochemical stains for adenovirus and CMV and in situ hybridization stain for EB virus (EBER) are negative.  
The specimen has four pieces of alveolated lung tissue. This is borderline adequate for the assessment of acute cellular rejection. Some medium-sized airways and bronchial wall is included. There are several small alveolar septal aggregates of small lymphocytes. These minimally expand the alveolar septa. One large lymphocyte aggregate, adjacent to anthrocotic pigment, is present and may be associated with a blood vessel.  There are no eosinophils or neutrophils. There is no epithelial damage. There are scattered hemosidern-laden macrophages. There is no suggestion of bronchiolitis obliterans or organizing pneumonia is seen with the elastic trichrome stain. Special stains for fungus (PAS with and without diastase, GMS) and Pneumocystis (GMS) are negative. Immunohistochemical stains for adenovirus and CMV and in situ hybridization stain for EB virus (EBER) are negative.  


===Final diagnosis===
===Final diagnosis===
Lung allograft, right lower lobe, transbronchial biopsies - ISHLT A1,B0,C0, minimal acute cellular rejection, with:
Lung allograft, right lower lobe, transbronchial biopsies - ISHLT A1,B0,C0, minimal acute cellular rejection, with:
<br>     i) specimen adequacy: borderline, four alveolated lung fragments assessed.
<br>   i) specimen adequacy: borderline, four alveolated lung fragments assessed.
<br>     ii) perivascular lymphocyte aggregates: one focus.
<br>   ii) perivascular lymphocyte aggregates: one focus.
<br>     iii) micro-organism special stains: negative fungal, Pneumocystis, CMV,
<br>   iii) micro-organism special stains: all negative (fungi (PAS, PAS-D, GMS), pneumocystis (GMS), CMV, adenovirus and EB virus).
adenovirus and EB virus.
<br>    iv) other: hemosiderin macrophages.
<br>    iv) other: hemosiderin macrophages.
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