Head and Neck Pathology

Cardiovascular

An Overview of

Cardiovascular Topics...

Transplant Pathology

Vasculitis

Ischemic Heart Disease

Cardiomyopathy

Valvular Heart Disease

Tumors

Myocarditis & Infections

Other

Transplant Pathology

Grading System

Download this open access article from the American Heart Association for full details of antibody mediated rejection

Hyperacute vs. Acute

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Quilty Lesion

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First Aid
Hyperacute Rejection

TIMING: 

  • Immediately or within hours after transplant

HISTOLOGIC CLUES:

  • Nonspecific changes

  • Hemorrhage

  • Edema

  • Platelet aggregates in vessels

  • Eventually, PMNs come in and are seen

HIGH YIELD FACTOIDS

Heart Confetti
Acute Rejection
  • Lymphocytes, Macrophages and Eosinophils

    • DDx of Eos: Drug rxn, toxoplasmosis, CMV​

  • NO Neutrophils (PMNs) 

    • (can be seen with ischemia, antibody-mediated rejection, or infection)

  • NO plasma cells!! 

    • (if present = Quilty lesion or PTLD)

HIGH YIELD FACTOIDS

Vasculature of the Heart
Acute Antibody Mediated Rejection
  • Capillary injury

  • Endothelial swelling

  • Intravascular macrophages

  • Edema

  • Hemorrhage

  • PMNs near capillaries

  • Thrombi

  • Myocyte necrosis

  • IgG, IgM, IgA, C3d, C4d, C1q

HISTOLOGY CLUES