In 1995 the International Society of Heart and Lung Transplantation (ISHLT)
reported histologic features of acute lung transplant rejection. This is based primarily on the level of mononuclear infiltrate about blood vessels in the transplant.
(1) perivascular (perivenular and periarteriolar) mononuclear infiltrate
(2) extension of the mononuclear infiltrate into the adjacent alveolar septae
(3) mononuclear infiltrate about the bronchi and bronchioles
Extension into Alveolar Septae
few and scattered
none to few scattered
limited extension into
diffuse extension into
• The presence of a moderate to dense infiltrate in the alveolar septae without a significant perivascular infiltrate may indicate some other process (viral pneumonia, etc.)
• A neutrophilic infiltrate suggests the presence of another or an additional process.
A mononuclear infiltrate about the bronchi or bronchioles was listed as absent or present.
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Specialty: Pulmonology, General Surgery