Final Diagnosis (Case 1)

1. MILD REGENERATION AND CHANGES SUGGESTIVE OF MILD IMMUNE ACTIVATION(See microscopic description); INSUFFICIENT FOR THE DIAGNOSIS OF ACUTE REJECTION.
2. INTACT MUCOSAL ARCHITECTURE.

Previous Biopsies on this Patient:
None

TPIS Related Resources:
Small Bowel Transplant Topics

Gross Description (Case 1)

Microscopic Description (Case 1)

(4 HE) The specimen consists of multiple ample fragments of small intestinal mucosa. The normal mucosal architecture is basically intact and the villi are long and delicate. A lymphoid patch is sampled, which shows some activated lymphocytes and a slight histiocytic infiltrate. In other areas, there is a slight increase in mononuclear cells in the lamina propria, some of which showed mild changes of activation. In addition, a slight increase in eosinophils is focally noted. However, there is no significant cryptitis. Occasional apoptotic bodies are noted, but these, in general, number less than 2/10 crypts. No viral inclusions are identified. The epithelium shows mild regenerative change, but Paneth cells are well represented.

Overall, the histopathologic changes are consistent with recent small bowel transplantation. Although there is some evidence of mild immune activation, it is insufficient for the diagnosis of acute rejection.