Figure 1. Manifestations of GvHD in our patient cohort.

For all micrographs, images were captured from scanned slides using nanozoomer 2.0RS digital slight scanner (Hamamatsu, Iawata city, Japan) at original magnifications of 100 X for A-C and 25X for D. These images were viewed and analyzed using NDP.view2 software (Hamamatsu, Iawata city, Japan). (A) Representative microscopic findings in GvHD vs. normal skin. Skin punch biopsy shows vacuolar degeneration with necrotic keratinocytes, features consistent with grade 2 GVHD (top) in contrast to an unremarkable skin biopsy (bottom). (B) Representative microscopic findings in GvHD vs. normal liver. Liver biopsy shows increased mixed inflammatory infiltrate including eosinophils in the portal triad (top) in contrast to an unremarkable liver biopsy. (C) Representative microscopic findings in GvHD vs. normal colon. Rectosigmoid biopsy shows mucosal ulceration with marked lymphocytic infiltrates, crypt epithelial damage and apoptosis, consistent with grade 3 GvHD (top) in contrast to an unremarkable rectosigmoid biopsy (bottom). (D) Representative microscopic findings in GvHD bone marrow. Markedly aplastic bone marrow for the stated age. This histologic diagnosis of GvHD was supported by chimerism studies in the patient’s peripheral blood showing increased donor’s cells in the circulation. (E) Gross appearance of characteristic erythematous macular and popular GvHD rash. (F) Gross appearance of characteristic erythematous, inflamed appearance of native colon in GvHD compared to normal colon. (G) Summary of the above manifestations of GvHD for each affected patient.