A 65-year-old male underwent routine biopsy for cardiac transplantation surveillance.
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Extensive and deep Quilty lesions and mild (1R) rejection.
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Rare patients have these extensive and deep Quilty lesions that can be deep in the tissue away from the epicardial surface. Quilty lesions have increased numbers of CD20+ cells as seen in this example. This case also nicely demonstrates positive CD21 staining which is specific for Quilty lesions. The presence of CD21 in the deep lesions indicates these were Quilty lesions and not higher level rejection. The patient was not treated and continues to do well.
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