Background: Liver transplant (LT) is a well‑established therapeutic strategy for endstage liver diseases. In the absence of a biopsy diagnosis, it is a common practice to increase immunosuppression for raised liver function tests, which may prove harmful in a non-rejection setting, hence, an accurate histopathological diagnosis from liver biopsy plays a significant role in the management of transplant recipients.We aim to study the spectrum of histopathological findings in post-transplant graft biopsies performed within 3 months of LT. Methods: This was a retrospective study of 81 patients who underwent LT at Medanta-The Medicity in the year 2022 and had a liver biopsy performed within 3 months following the LT. All biopsies with T cell-mediated rejection (TCMR) and antibody-mediated rejection (AMR) were graded according to the 2016 Banff criteria by two assessors in a blinded manner. Immunohistochemistry for anti-C4d (polyclonal; BioGenex, Fremont, CA, USA), anti-cytokeratin7 (clone RM416; BioSB, Santa Barbara, CA, USA), anti-cytokeratin-19 (clone RCK108; BioGenex, Fremont, CA, USA), and anti-CMV (clone 8B1.2, 1G5.2, and 2D4.2; BioSB, Santa Barbara, CA, USA) were performed wherever required. Results: The median age of the cohort was 45.5 years with a male predominance.The main indications of LT were alcoholic liver disease (22.22%), cryptogenic cirrhosis (20.98%), non alcoholic steatohepatitis (11.11%), and hepatocellular carcinoma (7.2%). A total of 113 biopsies were performed in 81 patients. The most common histopathological findings were TCMR (n=43, 53.08%), cholestatic changes (n=19, 23.45%), cholangitis (n=16, 19.75%), and preservation/reperfusion injury (PRI) (n=13, 16.04%). Two patients who underwent ABO-incompatible LT showed AMR. Conclusion The most common pathological diagnosis was TCMR, followed by cholestasis, cholangitis, and PRI. A non-TCMR diagnosis was present in 28.39% of cases.

BACKGROUND/AIMS: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology of adrenal masses helps in etiological diagnosis. The aim of this study was to evaluate the diagnostic yield of EUS-FNA of adrenal masses in cases where other imaging methods failed and/or were not feasible. METHODS: Twenty-one consecutive patients with adrenal masses, in whom adrenal FNA was performed because conventional imaging modalities failed and/or were not feasible, were prospectively evaluated over a period of 3 years. RESULTS: Of the 21 patients (mean age, 56+/-12.2 years; male:female ratio, 2:1), 12 had pyrexia of unknown origin and the other nine underwent evaluation for metastasis. The median lesion size was 2.4x1.6 cm. Ten patients were diagnosed with tuberculosis (shown by the presence of caseating granulomas [n=10] and acid-fast bacilli [n=4]). Two patients had EUS-FNA results suggestive of histoplasmosis. The other patients had metastatic lung carcinoma (n=6), hepatocellular carcinoma (n=1), and adrenal lipoma (n=1) and adrenal myelolipoma (n=1). EUS results were not suggestive of any particular etiology. No procedure-related adverse events occurred. CONCLUSIONS: EUS-FNA is a safe and effective method for evaluating adrenal masses, and it yields diagnosis in cases where tissue diagnosis is impossible or has failed using conventional imaging modalities.
Adrenal Glands* ; Biopsy, Fine-Needle* ; Carcinoma, Hepatocellular ; Diagnosis ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endosonography ; Fever ; Granuloma ; Histoplasmosis ; Humans ; Lipoma ; Lung ; Myelolipoma ; Neoplasm Metastasis ; Prospective Studies ; Tuberculosis