GVHD Post Show Quiz

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GVHD Post Show Quiz

Which of the following organisms can be a part of the differential diagnosis of GI GVHD?

CMV, adenovirus, and H. pylori should be ruled out and can present similarly on imaging.

CMV

Adenovirus

H. Pylori

All of the above

What is the histopathological distinctive feature of GI GVHD?

“Exploding crypts” are the hallmark histological finding of gastrointestinal GVHD.

apple green birefringence

exploding crypts

home wright rosettes

signet ring cells

Which of the following imaging findings would be present in acute GI GVHD?

While bowel wall strictures can be found in patients with GI GVHD, this is a chronic finding rather than an acute finding. Also, small bowel affected in a segmental pattern is more common in viral disease.

Bowel wall thickening, mucosal enhancement, diffusely affected small bowel

Bowel wall thickening, mucosal enhancement, segmentally affected small bowel

Bowel wall strictures, hepatosplenomegaly, segmentally affected small bowel

Bowel wall strictures, hepatosplenomegaly, diffusely affected small bowel

Which of the following is a hepatobiliary finding of GI GVHD?

Cholelithiasis, IPMNs, and liver cirrhosis are not common hepatobiliary findings of GI GVHD. Other hepatobiliary findings can include hepatosplenomegaly, biliary tract thickening and enhancement, and biliary sludge.

Cholelithiasis

intraductal papillary mucinous neoplasms

liver cirrhosis

periportal edema

Which of the following is the best protocolling option for suspected GI GVHD?

MRCP can have utility for intrahepatic involvement of GI GVHD, but is not the best modality for initial suspicion. Oral contrast can obscure mucosal ulceration or mucosal hyperenhancement. No IV contrast would have minimal utility because we want to see the mucosal hyperenhancement.

CT with IV contrast

CT without IV contrast

CT with oral contrast

MRCP

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