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ABDOMEN / GI tract general   33 / F,  Abdominal pain, diarrhea, B lymphocytic leukemia, s/p Allo PBSCT
2021-05-17
About Author
Authors Sunyoung Lee
Institution Severance Hospital, Yonsei University College of Medicine
E-mail carnival0126@gmail.com
About Case
Chief complaint
or Title
Abdominal pain, diarrhea, B lymphocytic leukemia, s/p Allo PBSCT
Subspecialty ABDOMEN / GI tract general
Classification Other / others
Age 33 Sex F
Difficulty For specialist
Modality CT
Case Figures
Click above Figure for more images.
Questions
What is your diagnosis?
Answer
Diagnosis Intestinal GVHD
Comments




  • Intestinal acute GVHD



  • Apoptosis of crypt cells +/- cryptitis

  • DDx) C. difficile colitis, CMV colitis, Neutropenic colitis

  • Endoscopy : Mucosal atrophy, bleeding,
    hyperemia

  • CT findings

    • Bowel wall thickening (usually less than
      6-8mm; severe thickening may suggest C. difficile, CMV infection)

    • Discontinous bowel involvement (Selective
      right colonic involvement is rare)

    • Abnormal mucosal enhancement (Replacement
      of highly vascular granulation tissue)

    • Bowel dilatation

    • Engorgement of vasa recta (Comb sign)

    • Mesenteric infiltration






















References
Keywords Intestinal GVHD
Attachment File -

Number of Applicants : 55
Correct Answer 44
Mayo Clinic Akitosih Inoue
Mayo Clinic Hiroaki Takahashi
Mallinckrot Institute of Radiology Naganathan Mani
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Semi-Correct Answer 2
The University of Tokyo Toshihiro Furuta
Osaka Red Cross Hospital Yusuke Utsunomiya
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