A small number of cases of Crohn disease associated with myelodysplastic syndromes or leukemia have been reported in adults in the last 25 years in the English-language medical literature. The authors report a case of a 9-year-old boy who developed Crohn disease and myelodysplastic syndrome concurrently. Analysis of his bone marrow showed a chromosome 20 abnormality. Although chromosome 20 abnormalities have been reported in a minority of these patients, the significance of this association remains unclear at the present time.

Immunosuppressive therapy for transplanted patients exposes them to a high risk of developing posttransplantation lymphoproliferative disorders (PTLD). We report the case of a child undergoing heart transplantation at seven months of age who developed PTLD at nine years of age, diagnosed by resection of a pulmonary nodule. In the past few years, because of the improved preservation of donated organs and of the larger experience with immunosuppressive therapy, a significant increase in the survival of children after heart transplantation has been observed. Thus, transplantation has become a broadly accepted therapeutic option for children and adolescents with congenital heart defects or cardiomyopathies in advanced stages 1-3 .Immunosuppressive therapy that transplanted patients have to undergo in order to prevent organ rejection exposes them to a high risk of developing neoplasms, mainly posttransplantation lymphoproliferative disorders (PTLD) 2-7 . The exact incidence of PTLD is unknown, ranging from 2% to 20%; however it is known to be higher among children 5,8 .A higher frequency of PTLD is observed among children because the great majority of them had not been exposed to the Epstein-Barr virus (EBV) prior to heart transplantation. Therefore, post-transplantation seroconversion is a significant risk factor for the development of PTLD 5,9,10 . Of the pediatric patients who seroconvert after heart transplantation, approximately 63% develop PTLD 9 .The EBV is believed to play a key role in the pathogenesis of PTLD 4 . This virus is able to enter B cells and induce their proliferation, which is normally controlled by many immune mechanisms such as proliferation and activation of cytotoxic T lymphocytes. Anti-rejection immunosuppressive drugs inhibit the response of these cytotoxic T lymphocytes, which results in the proliferation of B cells induced by EBV 7 .Treatment modalities for PTLD are varied and include reduction of the immunosuppressive therapy, control of EBV replication, conventional antineoplastic therapy (radiotherapy, chemotherapy, and surgery) and immunotherapy 8 . However, mortality rates are quite significant, varying according to prognostic factors and the treatment chosen 8,10 .The purpose of this publication is to report the case of a child undergoing heart transplantation at seven months of age who developed PTLD eight years and nine months later, diagnosed by resection of a pulmonary nodule. Case ReportMale, nine years old, male, who underwent heart transplantation at seven months of age because of dilated cardiomyopathy.In 2000, he had a respiratory disorder characterized by persistent cough with yellowish sputum, and was diagnosed with bronchopneumonia. He was initially treated with amoxicillin for fourteen days, and cefepime for thirteen days. In 2001, a control chest computed tomography (CT) revealed perihilar lymph nodes and solid masses within the lungs with a progressive evolution, suggestive of an infectious and secondarily tumoral disorder, and the patient was hospitalized for invest...