Quilty Effect: Its Definition and Significance, in Post-Cardiac Transplant Endomyocardial Biopsies with Focus on Our Experience

The recent trend of cardiac transplantation has been dramatic in our center, thus entailing the interpretation of endomyocardial biopsies in such patients.
With this fact borne in mind, we decided to review the cases from the point of view of a certain diagnostic challenge, namely quilty lesion or effect.
From April 2010 to December 2012, 42 patients with heart transplant have undergone endomyocardial biopsies and 63 samples were acquired.
Mean age of the patients was 30 ± 15.7 years (male/female: 34/8). Quilty effect was seen in 8 out of 63 samples (12.7%).
The incidence of quilty lesion was within the range defined for this finding. When the lesion extends to the underlying myocardial tissue, it can be a diagnostic challenge. In the eyes of an inexperienced observer, ISHLT grade 2 rejection may be diagnosed instead of invasive quilty lesion. Therefore, experienced pathologists play an important role in this regard in all the cardiovascular transplantation sites.