Transbronchial lung biopsy for the diagnosis of post-transplantation complications

Abstract

Objective To investigate the pathological characteristics of post-transplantation complications by using transbronchial lung biopsies (TBLB).Methods A retrospective analysis with TBLB was conducted on 16 patients who underwent lung transplantation in the First Affiliated Hospital,Guangzhou Medical University,between January 2003 and August 2013.Pathological features of lung tissues from patients with acute or chronic rejection were observed after HE staining.The cases with signs of infection were further studied by viral inclusion,PAS and methenamine silver staining.Results Of the 16 cases,6 had bacterial,2 fungal and 3 CMV infection.Two cases developed acute rejection (AR) and 2 chronic rejection (CR).In one case,the pathological diagnosis was not determined because of the massive fibrous exudates.Lung tissue in 2 AR cases was characterized by perivascular infiltration of mononuclear lymphocytes with possible signs of interstitial pulmonary infiltration.In 2 CR cases with,the lung tissue was characterized by fibroplasia and cicatrization inferior to the endothelia of small airways and/or blood vessels.Spores and hyphae were observed in lung tissues from 11 cases with infection,based on PAS and methenamine silver staining.Eosinophilic viral inclusion bodies were demonstrated by viral inclusion staining.Conclusion TBLB can be applied to diagnose the complications after lung transplantation,in particular the infection,followed by acute and chronic rejection. Key words: Lung transplantation; Bronchoscopy; Complications