Posttransplant Lymphoproliferative Disorders (PTLDs)

Abstract

Posttransplant lymphoproliferative disorders (PTLDs) are lymphoid or plasmacytic proliferations that develop as a consequence of immunosuppression in recipients of a solid organ, a bone marrow, or stem cell allografts. PTLDs include a broad spectrum of lesions that include early lesions (plasmacytic hyperplasia, infectious mononucleosis-like lesion), polymorphic PTLD, monomorphic PTLD (B-cell and T-cell variants), plasmacytoma-like lesions, and classical Hodgkin lymphomatype PTLD. PTLD usually presents between 6 and 17 months posttransplantation, in most cases with signs of systemic illness. Following liver transplantation, PTLD may develop in the liver, but overall this is a rare complication. The spectrum of hepatic PTLD after hepatic transplantation ranges from polymorphic PTLD to high-grade lymphomas and is most often related to EBV-infected lymphoid cells. Growth patterns comprise discrete nodules to diffuse patterns involving the entire organ.