In this example of moderate acute rejection, the portal triads are
obviously expanded by an
inflammatory infiltrate, which extends underneath the endothelium
of the portal veins(PV).
On closer examination, the infiltrate in this particular case
contains a significant number of
eosinophils(insets). On occasion, eosinophils can be the predominant
cell type early in
acute rejection, simulating an allergic reaction. An eosinophilic
portal infiltrate occuring more than 6 months after transplantation evokes
a wider differential diagnosis, which includes biliary obstruction, allergic
reactions and fungal infections.