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Airway Pathology in Lung Transplants

  • Amir LagsteinEmail author
  • Jeffrey Myers
Chapter
Part of the Respiratory Medicine book series (RM, volume 8)

Abstract

The histologic diagnosis of lung transplant rejection is based on the assessment of perivascular mononuclear cell inflammation, airway inflammation and fibrosis, and vasculopathic changes. This chapter describes the pathologic features of acute and chronic rejection of the small airways (i.e., lymphocytic and obliterative bronchiolitis). As transbronchial lung biopsy is the mainstay for the assessment of rejection, a brief discussion of some of the limitations of this technique is provided from the pathologist’s perspective. Several important and common entities that can mimic airway rejection are described with practical guidance for distinguishing these potential confounders on transbronchial biopsy. The non-rejection findings that are discussed include the normal biopsy, nonspecific forms of chronic bronchiolitis, cytomegalovirus and pneumocystis pneumonia, bronchiolitis obliterans-organizing pneumonia, and aspiration pneumonia.

Keywords

Lymphocytic bronchiolitis Obliterative bronchiolitis Bronchiolitis obliterans syndrome Acute rejection Chronic rejection 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of PathologyUniversity of MichiganAnn ArborUSA
  2. 2.Divisions of Anatomic Pathology and MLabs, Department of PathologyUniversity of MichiganAnn ArborUSA

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