Which histologic findings are characteristic of lung allograft bacterial infection?

Updated: Jun 06, 2019
  • Author: Aliya N Husain, MBBS, MD; Chief Editor: Philip T Cagle, MD  more...
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Answer

Answer

Bacterial infection

Histologically, the presence of neutrophils in airway epithelium (see the image below) raises the differential of bacterial infection versus grade B cellular rejection. Similar to other immunocompromised situations, gram-negative infections in transplant recipients may not elicit significant inflammatory responses. Bacterial cultures are prudent in light of clinical suspicion. Mycobacterial infection is very rare. It may cause granulomatous inflammation in the lung allograft recipient and can result from either Mycobacterium tuberculosis or atypical acid-fast organisms.

Lung transplantation-related pathology. This image Lung transplantation-related pathology. This image demonstrates bacterial infection: The presence of mostly neutrophils in both the submucosa and mucosa is most suggestive of an infection (hematoxylin and eosin [H&E], 200x).

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