Heart Allograft Biopsy Interpretation

Figure 1. Epstein-Barr virus associated lymphoproliferative disorders(PTLD) rarely involve the heart. When heart involvement is seen, it can closely mimic acute rejection because of the mononuclear predominance observed in the biopsy. In the right side of the photomicrograph, note the similarity to mild diffuse acute rejection (IHLTS grade 1B). The key distinguishing features, shown on the left side of the photomicrograph include the presence of cytological atypia in the mononuclear cell population and the paucity of eosinophils and other segmented leukocytes.

