Liver, Acute cellular (T cell mediated) rejection [LMP69631]

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Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Diseases of the Immune System
Diagnosis: 
Acute cellular (T-cell mediated) rejection
Species: 
Human
Organ System: 
Liver and Biliary Tract
Gender: 
Male
Age: 
45 years
Diagnosis Code: 
ICD-10: T86.4
Slide Contributor Information
Shao, T., Fischer, S.

Keywords

liver, cellular rejection, transplant

Clinical History

45 year-old male post liver transplant one month prior, biopsy performed due to elevated liver enzymes.

Clinical Discussion

Acute cellular rejection is a form of immune mediated inflammation and injury of liver allograft due to genetic mismatch. Patients are often asymptomatic but may present with fever or abdominal pain, or nonspecific elevation of liver function tests. Acute cellular rejection most often presents within the first month, but can occur at any time after transplantation. It is characterized by mixed portal inflammatory cell infiltrates, bile duct damage, and subendothelial venous inflammation.

This section shows a moderate portal infiltrate (lymphoid cells with eosinophils) along with venous subendothelial inflammation and bile duct injury by lympmhocytes. The features are in keeping with acute cellular (T-cell mediated) rejection.