A 15-year-old boy develops severe cardiomyopathy following myocarditis from Coxsackie virus and is placed on the cardiac transplant list. Two weeks following his cardiac transplantation from a matched donor, he develops dyspnea on exertion. Extensive evaluation is undertaken including cardiac catheterization and endomyocardial biopsy to assess for acute allograft rejection. Which of the following histologic findings is most consistent with this diagnosis?

Question

A 15-year-old boy develops severe cardiomyopathy following myocarditis from Coxsackie virus and is placed on the cardiac transplant list.  Two weeks following his cardiac transplantation from a matched donor, he develops dyspnea on exertion.  Extensive evaluation is undertaken including cardiac catheterization and endomyocardial biopsy to assess for acute allograft rejection.  Which of the following histologic findings is most consistent with this diagnosis?

Quizplus · Accepted Answer

Eductional Objective: Acute cardiac transplant rejection usually occurs weeks to months following transplantation and is primarily a cell-mediated process.  In acute cellular rejection, endomyocardial biopsy shows an interstitial lymphocytic infiltrate with myocyte damage.

A 15-Year-Old Boy Develops Severe Cardiomyopathy Following Myocarditis from Coxsackie