Elsevier

Human Pathology

Volume 16, Issue 4, April 1985, Pages 387-392
Human Pathology

A histopathologic study of gastric and small intestinal graft-versus-host disease following allogeneic bone marrow transplantation**

https://doi.org/10.1016/S0046-8177(85)80232-XGet rights and content

Twenty-two stomach and 14 small intestinal biopsy specimens from 24 allogeneic bone marrow transplant recipients were reviewed to evaluate the histopathologic changes of graft-versus-host disease (GVHD) in these organs. Associations between these results and clinical symptoms and other biopsy results were sought. In both organs, single epithelial cell necrosis was found to correlate with GVHD. Gastric GVHD was diagnosed in eight patients and small intestinal GVHD in four. Gastric GVHD was characterized by nausea, vomiting, and upper abdominal pain without diarrhea (the latter being present in only two patients), while all four of the patients with small intestinal GVHD had upper gastrointestinal symptoms and diarrhea. These symptoms correlated with concurrent rectal biopsy findings; pathologic alterations were seen in only one of six specimens from patients with gastric GVHD but in three of four with small intestinal GVHD. These findings suggest that stomach biopsy may be necessary to diagnose GVHD in patients with upper gastrointestinal symptoms but no diarrhea and normal rectal biopsy specimens. Diagnostic problems may arise in the early posttransplantation period, when the effects of cytoreductive therapy may simulate GVHD, and in patients with gastrointestinal cytomegalovirus infection, which may also produce changes identical to those of GVHD.

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**

Presented in part at the 73rd Annual Meeting of the International Academy of Pathology, U.S.-Canadian Division, San Francisco, California, March 12–16, 1984. Supported in part by grant CA P01-21737 from the National Cancer Institute.

*

from the Bone Marrow Transplantation Unit, Departments of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota

1

Dr. Snover is a Junior Faculty Clinical Fellow of the American Cancer Society.

from the Bone Marrow Transplantation Unit, Departments of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota

from the Bone Marrow Transplantation Unit, Departments of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota

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