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CT Features with Pathologic Correlation of Acute Gastrointestinal Graft-Versus-Host Disease After Bone Marrow Transplantation in Adults

¹ Department of Radiology, Section of Abdominal Imaging and Intervention, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115.
² Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.

View larger version (131K): [in a new window]   Fig. 1. —49-year-old man with pathologically confirmed grade IV acute gastrointestinal graft-versus-host disease. Axial contrast-enhanced helical CT scan shows diffuse wall thickening involving small (short arrows) and large (long arrow) bowel in region of ileocecal valve.

View larger version (104K): [in a new window]   Fig. 2. —43-year-old woman with pathologically confirmed grade IV acute gastrointestinal graft-versus-host disease. Axial contrast-enhanced helical CT scan shows small-bowel wall thickening (short arrow) with proximal dilatation (long arrow).

View larger version (116K): [in a new window]   Fig. 3. —41-year-old woman with pathologically confirmed grade IV acute gastrointestinal graft-versus-host disease. Axial contrast-enhanced helical CT scan shows ascites and small-bowel wall thickening with mucosal enhancement (arrows).

View larger version (125K): [in a new window]   Fig. 4. —50-year-old woman with pathologically confirmed grade IV acute gastrointestinal graft-versus-host disease. Axial contrast-enhanced helical CT scan shows ascites, small- and large-bowel wall thickening, and mucosal and serosal enhancement (arrows).

View larger version (105K): [in a new window]   Fig. 5. —43-year-old woman with pathologically confirmed grade IV acute gastrointestinal graft-versus-host disease. Axial contrast-enhanced helical CT scan shows engorgement of vasa recta (arrows) that is more pronounced adjacent to thickened bowel wall segments.

View larger version (152K): [in a new window]   Fig. 6A. —49-year-old man with pathologically confirmed grade IV acute gastrointestinal graft-versus-host disease. Photomicrographs of histopathologic rectosigmoid biopsy specimens reveal findings that confirm diagnosis. Low-power image (A) shows surface ulceration (arrow, A, indicating surface), with absence of glands in mucosa, crypt cell dropout, and nearly complete loss of epithelium, whereas high-power image (B) reveals epithelial cell apoptosis (arrow, B) and lymphocytic infiltration of lamina propria. (H and E, both slides)

View larger version (135K): [in a new window]   Fig. 6B. —49-year-old man with pathologically confirmed grade IV acute gastrointestinal graft-versus-host disease. Photomicrographs of histopathologic rectosigmoid biopsy specimens reveal findings that confirm diagnosis. Low-power image (A) shows surface ulceration (arrow, A, indicating surface), with absence of glands in mucosa, crypt cell dropout, and nearly complete loss of epithelium, whereas high-power image (B) reveals epithelial cell apoptosis (arrow, B) and lymphocytic infiltration of lamina propria. (H and E, both slides)

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