Table of Contents
Definition / general | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Electron microscopy imagesCite this page: Jain D. Graft versus host disease. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyeGVHDconjunctiva.html. Accessed January 10th, 2025.
Definition / general
- Occurs in up to 80% of chronic graft versus host disease patients with allogeneic hematopoietic transplants
- Most commonly affects conjunctiva, lacrimal gland, meibomian glands; also cornea, choroid
- Bulbar conjunctiva is biopsied for diagnosis
- Conjunctival and lacrimal gland fibrosis may be due to epithelial mesenchymal transition (Am J Pathol 2009;175:2372)
- Modified Lerner classification of bulbar GVHD seems to have prognostic value (Graefes Arch Clin Exp Ophthalmol 2007;245:1001)
Microscopic (histologic) description
- Reduced goblet cells (Eur J Ophthalmol 2006;16:17)
- Pseudomembrane due to loss of conjunctival epithelium
- May have keratinization
- Increased ICAM-1 expression (Eur J Ophthalmol 2006;16:17)
- Reduced mucosal microvilli (Bone Marrow Transplant 2012;47:416)
Microscopic (histologic) images
Cytology description
- Conjunctival scrape cytology:
- Atypical epithelial cells
- Loss of goblet cells
- Epithelial cells with vacuolated or coarse, granular cytoplasm
- Squamous metaplasia
- Prominent inflammatory background (Acta Cytol 2010;54:272)
- Expression of Th1-associated chemokines (Bone Marrow Transplant 2010;45:1340)