Interstitial and airspace granulation tissue reactions in lung transplant recipients

Am J Surg Pathol. 1992 Sep;16(9):877-84. doi: 10.1097/00000478-199209000-00006.


Twenty-three transbronchial and open-lung biopsies from patients who had received a lung allograft displayed fibromyxoid plugs of granulation tissue within airways, airspaces, and the interstitium in a patchy distribution. This granulation tissue-like reaction was identified in three clinicopathologic settings. First, 11 cases occurred with acute lung rejection, of which four cases had been partially treated with steroids for a previous rejection episode. Second, in seven cases the fibromyxoid tissue represented the healing phase of previously diagnosed diffuse alveolar damage resulting from preservation (harvest) injury to the allograft. Third, five cases were related to infection: herpes, Pseudomonas, Serratia, Staphylococcus, and Pneumocystis pneumonias. Although organizing pneumonia-like responses usually suggest an infectious episode, this reaction may be seen as a manifestation of acute lung rejection or ischemic lung injury.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biopsy
  • Bronchi / microbiology
  • Bronchi / pathology
  • Bronchi / physiology
  • Graft Rejection
  • Granulation Tissue / pathology
  • Granulation Tissue / physiology*
  • Humans
  • Lung / microbiology
  • Lung / pathology
  • Lung / physiology
  • Lung Transplantation / immunology
  • Lung Transplantation / pathology
  • Lung Transplantation / physiology*
  • Pneumocystis / isolation & purification
  • Pneumonia, Pneumocystis / complications
  • Pneumonia, Pneumocystis / pathology
  • Pseudomonas / isolation & purification
  • Pseudomonas Infections / complications
  • Pseudomonas Infections / pathology
  • Staphylococcal Infections / complications
  • Staphylococcal Infections / pathology
  • Staphylococcus / isolation & purification
  • Transplantation, Homologous