In a kidney transplant recipient, the classic biopsy finding of endarteritis with mononuclear cell infiltration in the vessel wall is most characteristic of which type of rejection?
- A Hyperacute rejection
- B Acute cellular rejection (Type IIA) ✓
- C Acute antibody-mediated rejection
- D Chronic allograft nephropathy
Correct answer: B. Acute cellular rejection (Type IIA)
Explanation
Acute cellular rejection (Type IIA per Banff classification) is characterized histologically by endarteritis — mononuclear inflammatory cells within the vessel intima (intimal arteritis) — in addition to tubulitis and interstitial infiltration. Hyperacute rejection occurs within minutes with thrombosis due to preformed antibodies. Acute antibody-mediated rejection shows peritubular capillaritis with C4d deposits. Chronic allograft nephropathy demonstrates obliterative vasculopathy and interstitial fibrosis.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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