Contributed by Samuel A.
Yousem, M.D.
PATIENT HISTORY:
The patient is a 38 year old white male status post bilateral
lung transplant for cystic fibrosis, with history of grade 3
rejection. Patient has stable pulmonary function tests.
Final Diagnosis (Case 3)
ALLOGRAFT LUNG, RIGHT LOWER LOBE, TRANSBRONCHIAL BIOPSY -
- LOW GRADE ACUTE CELLULAR REJECTION (See comment).
- FOCAL MUCOUS PLUGGING OF AIRWAYS WITH MILD CHRONIC
INFLAMMATION.
- FOCAL GIANT CELL REACTION TO EXOGENOUS MATERIAL.
- INTERSTITIAL DYSTROPHIC CALCIFICATION WITH ALVEOLAR
HEMOSIDEROSIS.
Comment:
The right lower lobe biopsy is somewhat unique for the presence of
more mononuclear cells within the interstitium than expected. This
finding is noted in the absence of perivascular infiltrates. The
morphology suggests a partially treated acute rejection, of low grade
intensity (minimal/mild).
Previous Biopsies on this Patient:
Case 1
TPIS Related Resources:
Lung Allograft Biopsy Rejection
Criteria
Lung Transplant Topics
Gross Description - Case 3
The specimen is received unfixed in saline labeled
"transbronchial biopsy right lower lobe" and it consists of five
irregular segments of soft, tan to red and erythematous tissue,
0.2 to 0.5 cm. in greatest dimension, and two minute fragments of
red, friable debris. The specimen is agitated in buffered
formalin and totally submitted labeled 1ATB.
Microscopic Description - Case 3
The microscopic examination substantiates the diagnosis.
Please mail comments, corrections or suggestions to the
TPIS administration at the UPMC.
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