Imaging of Posttransplantation Lymphoproliferative Disorder after Solid Organ Transplantation

Abstract

Posttransplantation lymphoproliferative disorders (PTLDs) are a heterogeneous group of diseases that represent uncommon complications of transplantation and can lead to significant morbidity and mortality. PTLD is most prevalent during the first year following transplantation and occurs most frequently in multiorgan transplant recipients, followed by bowel, heart-lung, and lung recipients. It may involve any of the organ systems, with disease manifestation and the anatomic pattern of organ involvement being highly dependent on the type of transplantation. The current classification system includes four subtypes that have different prognoses requiring different treatment strategies. Tissue sampling is necessary for diagnosis and further subcategorization. The majority of cases are characterized by B-cell proliferation and are related to infection from Epstein-Barr virus. Knowledge of the distribution and radiologic features of PTLD allows the radiologist to play a pivotal role in making an early diagnosis and in guiding biopsy.

Idiopatik Periportal Lenfadenopati

“…Tanı serolojik ve klinik kolerasyon ile konur. Ancak görüntüleme ile saptanan periportal bir kitle klinik bulguların uyumlu olduğu durumda PLH için son derece tipik bir bulgudur (5). Lenfomada % 20-30 olguda beraberinde kilo kaybı, gece terlemesi ve ateş gözlenebilir.…”

Incidência e aspectos de imagem do linfoma pós-transplante hepático em crianças

“…In the chest, pulmonary nodules or masses and mediastinal lymphadenopathy constitute the most common manifestations. In head and neck, the involvement is most frequently characterized by the presence of a focal mass in the Waldeyer's tonsillar ring and cervical lymphadenopathy (4) . Considering that PTLD frequently occurs in extranodal sites, PET-CT may be extremely useful in such cases (4) .…”

“…In head and neck, the involvement is most frequently characterized by the presence of a focal mass in the Waldeyer's tonsillar ring and cervical lymphadenopathy (4) . Considering that PTLD frequently occurs in extranodal sites, PET-CT may be extremely useful in such cases (4) . PET-CT performance is comparable to axial methods in the early staging of PTLD and demonstrates a higher potential to an earlier evaluation of treatment response than conventional methods (19) .…”

“…Most frequently, clinical manifestations of PTLD occur within the first year after transplantation and may affect any organ in the body, either focally or diffusely (2)(3)(4) . The spectrum of such disorder includes hyperplastic lesions, polymorphic or monomorphic disease, the latter including lymphomas which represent the most severe form of involvement (5) .…”

Post-transplantation lymphoproliferative disorder in a child with multivisceral transplant

“…Most cases are associated with B-lymphocyte proliferation and EBV infection [1]. PTLD usually occurs within 1 year of transplantation and is most prevalent in multivisceral transplant recipients [2].…”