Monomorphic post-transplant lymphoproliferative disorder of the tongue: case report and review of literature

Gonzalez‐Cuyar, Luis F.; Távora, Fábio; Burke, Allen; Gocke, Christopher D.; Zimrin, Ann B.; Sauk, John J.; Zhao, X. Frank

doi:10.1186/1746-1596-2-49

Cited by 8 publications

(8 citation statements)

References 27 publications

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“…It is not clear why homing of tumour cells is more likely at extracranial mucosa‐associated lymphatic tissues such as the gastrointestinal tract. We and others found a few PTLD in the oral cavity and simultaneously or sequentially in other anatomical sites . As, in general, these cases are rare and IgH analysis often shows two clonally independent diseases, naso‐ or oropharynx PTLD is not related to a higher risk of tumour spreading .…”

Section: Discussionmentioning

confidence: 52%

“…To increase the number of cases, we combined our own data with data from the literature. From the literature, we identified a total of 61 reports on monomorphic B‐PTLD ( n = 34) , T‐PTLD ( n = 7) and polymorphic PTLD ( n = 20) with sinonasal and/or oro‐/nasopharyngeal manifestation. Therefore, including our cases, a total of 140 cases were evaluated (Table ).…”

Section: Resultsmentioning

confidence: 99%

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Post-transplant lymphoproliferative disorders with naso- and oropharyngeal manifestation

et al. 2015

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SummaryThe nasopharyngeal/oropharyngeal lymphatic tissues represent the anatomical site of Epstein-Barr virus (EBV) entry. Post-transplant lymphoproliferative disorders (PTLD) are often associated with EBV, but little is known about the characteristics of nasopharyngeal/oropharyngeal mass-forming PTLD. Retrospective evaluation of our own PTLD database (n = 79) and the PubMed â database (n = 61) has been performed. Sinonasal/oro-/nasopharyngeal lymphatic masses were early lesions (n = 54/140, 38.5%), polymorphic PTLD (n = 32/140, 23%), monomorphic B-PTLD (n = 47/140, 33.5%) and T-PTLD (n = 7/140, 5%). Onefourth of lesions manifested as masses in the Waldeyer's ring, and in two-thirds of cases, swelling of tonsils was related to manifestation of benign early lesions. Tonsil infiltration by polymorphic PTLD and monomorphic PTLD was present in one-third of cases. Extratonsillar masses were mainly monomorphic PTLD. Meta-analysis of our data in combination with previously published data revealed that lung transplantation and young patients are at a higher risk for earlier manifestation of monomorphic PTLD. Therapy is similar to PTLD therapy strategies, in general reduced immunosuppression and chemotherapy for polymorphic and monomorphic PTLD, and diagnostic and therapeutic surgical gross tumour resection of tonsillar/adenoid lesions. In summary, it is relevant for the clinical differential diagnosis that oro-/nasopharyngeal aggressive PTLD manifested in~30% as tonsillar masses and >90% at extratonsillar sites.

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Section: Discussionmentioning

confidence: 52%

Section: Resultsmentioning

confidence: 99%

Post-transplant lymphoproliferative disorders with naso- and oropharyngeal manifestation

et al. 2015

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“…Gastrointestinal involvement in PTLDs is suggestive of oral PTLD, but definitive diagnosis is by biopsy (Figures 2 and 3). Reports of oral PTLDs are few, with 25 cases located in the literature – more than half in renal transplant recipients (reviewed in: Gonzalez‐Cuyar et al , 2007; Ojha et al , 2008; León et al , 2011; other case reports: Papadaki et al , 2000; Wang et al , 2000; Henry et al , 2008; Apichai et al , 2009). Only two cases have been found among HSCT recipients (Raut et al , 2000; Wang et al , 2000).…”

Section: Oral Post‐transplantation Lymphoproliferative Disordersmentioning

confidence: 99%

“… Microphotographs of monomorphic post‐transplantation lymphoproliferative disorder (PTLD) of the tongue. ( a ) Large lymphoid cells with abundant cytoplasm, vesicular nuclei and prominent nucleoli (hematoxylin‐eosin stained, 400× magnification); ( b ) Neoplastic cells positive for CD20 (B‐cell marker, 400× magnification); ( c ) Neoplastic cells positive for Epstein–Barr virus (EBV) latent membrane protein (immunoperoxidase stain, 400× magnification) (courtesy of Dr. Frank Xianfeng Zhao, from Gonzalez‐Cuyar et al , 2007) …”

Section: Oral Post‐transplantation Lymphoproliferative Disordersmentioning

confidence: 99%

Orofacial diseases in solid organ and hematopoietic stem cell transplant recipients

Petti¹,

Polimeni

Berloco

et al. 2012

Oral Diseases

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“…Pulmonary complications such as post-transplant lymphoproliferative disorder in the lung are also seen after other solid organ transplantation like kidney transplantion [16-18]. The morphological changes in the lung are diverse; therefore the accurate diagnosis for lung histopathological changes after organ transplantation is very difficult.…”

Section: Discussionmentioning

confidence: 99%

T cell immunohistochemistry refines lung transplant acute rejection diagnosis and grading

et al. 2013

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ObjectiveLung transplant volume has been increasing. However, inaccurate and uncertain diagnosis for lung transplant rejection hurdles long-term outcome due to, in part, interobserver variability in rejection grading. Therefore, a more reliable method to facilitate diagnosing and grading rejection is warranted.MethodRat lung grafts were harvested on day 3, 7, 14 and 28 post transplant for histological and immunohistochemical assessment. No immunosuppressive treatment was administered. We explored the value of interstitial T lymphocytes quantification by immunohistochemistry and compared the role of T cell immunohistochemistry with H&E staining in diagnosing and grading lung transplant rejection.ResultsTypical acute rejection from grade A1 to A4 was found. Rejection severity was heterogeneously distributed in one-third transplanted lungs (14/40): lesions in apex and center were more augmented than in the base and periphery of the grafts, respectively. Immunohistochemistry showed profound difference in T lymphocyte infiltration among grade A1 to A4 rejections. The coincidence rate of H&E and immunohistochemistry was 77.5%. The amount of interstitial T lymphocyte infiltration increased gradually with the upgrading of rejection. The statistical analysis demonstrated that the difference in the amount of interstitial T lymphocytes between grade A2 and A3 was not obvious. However, T lymphocytes in lung tissue of grade A4 were significantly more abundant than in other grades.ConclusionsRejection severity was heterogeneously distributed within lung grafts. Immunohistochemistry improves the sensitivity and specificity of rejection diagnosis, and interstitial T lymphocyte quantitation has potential value in diagnosing and monitoring lung allograft rejection.Virtual slidesThe virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1536075282108217.

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Monomorphic post-transplant lymphoproliferative disorder of the tongue: case report and review of literature

Abstract: Background: Post-transplant lymphoproliferative disorder (PTLD) is a spectrum of hematological diseases arising in context of immunosuppression after organ transplantation. PTLD can involve any organ; however, it is extremely rare in oral cavity.

Cited by 8 publications

References 27 publications

Post-transplant lymphoproliferative disorders with naso- and oropharyngeal manifestation

Post-transplant lymphoproliferative disorders with naso- and oropharyngeal manifestation

Orofacial diseases in solid organ and hematopoietic stem cell transplant recipients

T cell immunohistochemistry refines lung transplant acute rejection diagnosis and grading

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