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Difference between revisions of "Talk:Heart transplant pathology"
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Talk:Heart transplant pathology (view source)
Revision as of 16:31, 22 March 2011
, 16:31, 22 March 2011more
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==Biopsy - 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:<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 - | ==Biopsy - mild cellular 2== | ||
===Microscopic=== | ===Microscopic=== | ||
The | 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== | |||
Heart allograft, endomyocardial biopsies x 5 - ISHLT Grade | 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> | ||
== 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. | ||