Graft versus host disease in lung transplant patient for cystic fibrosis

Case contributed by Dr Jeremy Frank

Presentation

Status post lung transplant. Abdominal pain.

Patient Data

Age: 30
Gender: Female
  • diffuse intestinal mural thickening and mucosal enhancement
  • dilated fluid-filled loops of small bowel and colon
  • complete fatty replacement of pancreatic parenchyma (history of cystic fibrosis)
  • mature teratoma of right ovary, with fatty attenuation, and teeth
  • L2 vertebral body haemangioma

Case Discussion

Graft vs host disease

  • the allogeneic lung transplant's T cells attack the histo-incompatible, immunocompromised host
  • severe intestinal inflammation, abdominal pain, diarrhoea
  • sloughed mucosa may cause enhancing granulation tissue, in dilated fluid-filled bowel loops

Cystic fibrosis

  • total fatty replacement of the pancreatic parenchyma, due to exocrine disease.
  • pulmonary disease, necessitated the lung transplant in this patient

Ovarian teratoma (incidental finding)

  • benign well differentiated congenital tumour, with ectodermal, endodermal and/or mesodermal elements
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Case information

rID: 32687
Case created: 9th Dec 2014
Last edited: 17th Sep 2015
Inclusion in quiz mode: Included

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