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Reporting of Transbronchial Biopsies in Lung or Heart/Lung Transplant Recipients

Dr Sampurna Roy MD

 

                                                                                                                      

 

The three main complications of transplantation are:

(i) Rejection (ii) Infection and (iii) Neoplasia.

Biopsies are often taken from each lobe of both lungs.

Multiple sections from each block may be required.

Following clinical details should be provided to the histopathologist:

Age and sex of the patient ; clinical state of the patient ; time since transplant ; drugs used for immunosuppression ;

Other investigations - Radiological features and diagnosis and results of microbiological tests.

 

                                                                                      

The following points should included in the histopathology report:

- Inflammation:

- Neutrophil infiltrate in pneumonia;

- Perivascular lymphocytic infiltrate in early rejection;

- Peribronchial lymphocytic infiltrate in late rejection, associated with obliterative bronchiolitis and intimal fibrosis of pulmonary arteries (often mild);

- Granulomas in mycobacterial and fungal infections;

- Viral inclusions: Cytomegalovirus , Adenovirus , Herpes Simplex , Varicella ;

- Neoplasia ;

- Lymphoma, especially B cell;

- Squamous Cell Carcinoma.

 

Further reading:

The role of transbronchial lung biopsy in the treatment of lung transplant recipients. An analysis of 200 consecutive procedures.

Transbronchial biopsy in heart and lung transplantation: clinicopathologic correlations.

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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