Posttransplant lymphoproliferative disorder: A pictorial review

Abstract

Posttransplant lymphoproliferative disorder (PTLD) is a serious and potentially fatal complication after solid organ and haemopoietic stem cell transplantation. The frequency of PTLD varies with the type of organ transplant but overall it affects 2-10% of all solid organ transplant recipients. Most cases develop within 1 year after the transplant, although occasional cases present 5-10 years later. Posttransplant lymphoproliferative disorder is clinically and pathologically heterogeneous - the majority are of the non-Hodgkin's lymphoma type, whereas Hodgkin's lymphoma arising after transplantation is rare. We have retrospectively reviewed patients with a histological diagnosis of PTLD after a solid organ transplant. We present the imaging features and a clinical review of this condition. Early diagnosis of PTLD may alter the management and outcome of the disease. The radiologist can play a vital role in establishing the diagnosis by imaging features supplemented with percutaneous biopsy and also in monitoring the disease response to treatment.

Is there a difference in post-transplant lymphoproliferative disorder in adults after solid organ and haematologic stem cell transplantation? Experience in 41 patients

“…15,18 Gastrointestinal involvement in PTLD (stomach, small bowel and colon) occurred in patients with HST and SOT and manifested as bowel wall thickening, aneurysmal bowel dilatation and bowel perforation, also in concordance with known description of GI PTLD. 8,20,24,26,27 Similar to the study by Pickhardt and Siegel,20 in which 30.5% of patients with SOT presented with gastrointestinal PTLD, 23% of patients with SOT in our cohort presented with bowel PTLD. GI PTLD was the most common site of PTLD in renal transplant recipients, which is similar to the European collaborative study.…”

Posttransplantation lymphoproliferative disorder involving liver after renal transplantation

“…1A and B), 2) ill-defined infiltrative or geographic pattern, which has poorly-marginated but can be identified against a normally enhancing background liver and can resemble focal fatty infiltration, 3) a heterogeneous mass at porta hepatis, which can directly extend into the biliary tree or gallbladder, with resultant hepatomegaly or biliary obstruction 3,9,11. On ultrasonography, these hepatic lesions appear hypoechoic (Fig.…”

“…On ultrasonography, these hepatic lesions appear hypoechoic (Fig. 2) and they can be confused with liver abscesses on ultrasound 11,12…”

“…Splenic involvement is less common, manifesting as focal masses with or without splenomegaly 11,12. Imaging findings of hollow viscus involvement also resemble those of lymphoma, although ulceration and perforation is more common in PTLD 11,13.…”

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

“…2012 Jan/Fev;45(1): [7][8][9][10][11] ing findings, the radiologist plays a relevant role in the collection of material for histopathological analysis by means of imageguided percutaneous biopsy and in the evaluation of the treatment response . Despite the fact that some studies have already evaluated the incidence and clinical presentation of PTLD (8)(9)(10)(11) , few authors have approached the imaging findings associated with this disease.…”