Open AccessPost-transplant lymphoproliferative disorder presenting with multifocal aggressive osseous lesions
Author(s) -
James Anthony Korf,
M. K. Jesse,
Theodore C. Schultheiss
Publication year - 2019
Publication title -
bjr case reports
Language(s) - English
Resource type - Journals
ISSN - 2055-7159
DOI - 10.1259/bjrcr.20180045
Subject(s) - immunosuppression , medicine , lymphoproliferative disorders , post transplant lymphoproliferative disorder , pathology , etiology , transplantation , biopsy , epstein–barr virus , organ transplantation , epstein–barr virus infection , immunology , dermatology , lymphoma , virus
Post-transplantation lymphoproliferative disorder (PTLD) encompasses a broad category of lymphoid and plasmacytic proliferations that occur following solid organ and/or allogeneic stem cell transplantation. PTLD manifests in the setting of chronic immunosuppression and is thought to be associated with the Epstein Barr Virus, although Epstein Barr Virus infection or reactivation is not required for the process to occur. Pathologic correlation is necessary for diagnosis with B-cell lymphocytes the most commonly isolated cellular etiology. There is a broad range of clinical and imaging presentations of PTLD with intestinal and nodal involvement being the most common. Imaging plays an integral part in the diagnosis and management of PTLD, as it is utilized in the initial diagnosis and staging, guiding biopsy of lesions, and gauging treatment response. Presenting symptoms of PTLD are often vague and nonspecific and depend on the organ systems affected. Musculoskeletal involvement is especially rare, with only a few cases described in the literature. We present a case with multifocal osseous manifestations of PTLD occurring years after a renal living donor transplant.