Small bowel (small intestine) - Graft versus host disease

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Small bowel (small intestine)

Inflammatory disorders

Graft versus host disease

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 15 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Apoptotic cells and fibrosis commonly associated with allogeneic bone marrow transplant (Dig Dis Sci 2012;57:720)
● Recommended to delay biopsies until week 4 of immunosuppressive therapy or later
● Symptoms include severe watery diarrhea, changes in skin and liver

Case reports
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● 22 month old girl with AML and small bowel obstruction post bone marrow transplant (Korean J Hematol 2012;47:142)

Gross images
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Severe chronic GVHD involving small intestine, leading to obstruction of terminal ileum

Micro description
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● Acute: epithelial crypt apoptosis with minimal inflammation; severe cases have sloughing of mucosa
● Chronic: lamina propria fibrosis and submucosal fibrosis extending up to serosa

Micro images
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Severe loss of mucosal epithelium, many basal single cell apoptotic bodies, crypt dropout, submucosal/subserosal fibrosis

End of Small bowel (small intestine) > Inflammatory disorders > Graft versus host disease

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