PMID: 9298880Sep 23, 1997

Gastric graft-versus-host disease: a blinded histologic study

The American Journal of Surgical Pathology
Kay WashingtonH R Krigman


Acute graft-versus-host disease (GvHD) of the upper gastrointestinal (GI) tract is common after allogeneic bone marrow transplantation (BMT). However, diagnosis cannot be made on clinical presentation and endoscopic findings alone, because these are nonspecific, and histologic confirmation is often desirable. The diagnosis of gastric GvHD is often based on subtle findings with considerable potential for variability in interpretation. Evaluation of the reproducibility of diagnosis and recognition of histologic features of gastric GvHD was based on blinded review of 56 gastric biopsies (24 from patients with allogeneic BMT or unrelated umbilical cord blood transplantation and 32 control biopsies from patients who did not undergo BMT, of whom eight had active GI cytomegalovirus [CMV] infection). Histologic criteria for GvHD were apoptosis and gland destruction, sparse inflammatory infiltrate, and granular eosinophilic debris in dilated glands. Seventeen patients (22 biopsies) were judged to have clinical GvHD on the basis of skin or liver involvement and GI symptoms without other known cause. Eighteen of these 22 gastric biopsies were classified as GvHD by at least two of the three pathologists on initial review. Blinded histologi...Continue Reading


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Related Concepts

Endoscopy (Procedure)
Primary Immune Deficiency Disorder
Immunologic Deficiency Syndromes
Apoptosis, Intrinsic Pathway
Acute GVH Disease
Graft-vs-Host Disease
Bone Marrow
HIV Infections
Graft-Versus-Host Disease Pathway

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