Lung transplant pathology

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Lung transplant pathology is a little subspecialty in the subspecialty of lung pathology.

Classification - rejection

Types:[1]

  • A. Acute rejection.
    • A0 (none), A1 (minimal), A2 (mild), A3 (moderate), A4 (severe).
  • B. Small airway inflammation/lymphocytic bronchiolitis.
    • B0 (none), B1R (low-grade), B2R (high-grade), BX (cannot be graded).
  • C. Chronic airway rejection - broncholitis obliterans.
    • C0 (absent), C1 (present).
  • D. Chronic vascular rejection.

Rejection

General

  • Usual DDx is infection.

Microscopic

Features:[2]

  • Perivascular lymphocytes / plasmacytoid cells.
  • +/-Macrophages.
  • +/-Eosinophils.
  • +/-Neutrophils.

Images:

Post-transplant lymphoproliferative disorder

  • A rare complication of transplants.
  • Similar to DLBCL.

See also

References

  1. Stewart S, Fishbein MC, Snell GI, et al. (December 2007). "Revision of the 1996 working formulation for the standardization of nomenclature in the diagnosis of lung rejection". J. Heart Lung Transplant. 26 (12): 1229–42. doi:10.1016/j.healun.2007.10.017. PMID 18096473.
  2. Leslie, Kevin O.; Wick, Mark R. (2004). Practical Pulmonary Pathology: A Diagnostic Approach (1st ed.). Churchill Livingstone. pp. 407. ISBN 978-0443066313.