Recurrent Posttransplant Lymphoproliferative Disorder Involving the Larynx and Trachea: Case Report and Review of the Literature

Banks, Colin; Stallworth, Christina; White, David R.

doi:10.1177/000348941212100502

Cited by 13 publications

(13 citation statements)

References 16 publications

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“…As in our patient population, there are reports in the literature of patients who presented with stridor, airway obstruction and laryngeal findings consistent with lymphoproliferation, but did not meet criteria for PTLD or have biopsies positive for EBV . The underlying cause of this EBV‐negative disease remains largely unknown.…”

Section: Discussionmentioning

confidence: 87%

Airway inflammation and symptoms in children following liver and heart transplantation

Redmann

Bucuvalas

Wood

et al. 2017

Clinical Transplantation

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Section: Discussionmentioning

confidence: 87%

Airway inflammation and symptoms in children following liver and heart transplantation

Redmann

Bucuvalas

Wood

et al. 2017

Clinical Transplantation

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“…Presentation involves the head and neck in 25%‐63% of cases, with a single report describing 39% for heart transplant patients. In all of the previous reports, PTLD in the airway was exceedingly rare …”

Section: Discussionmentioning

confidence: 84%

Airway plaque presenting after alteration of immunosuppression in a pediatric patient remote from heart transplantation

Ryan

Absalon

Alarcón

et al. 2017

Pediatric Transplantation

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Success after solid organ transplantation is dependent on the proper balance of immunosuppression to prevent rejection of the allograft while limiting the risk of developing infections and malignancy. We present a 9-year-old girl, remote from transplant, who presented with airway plaque after a change in immunosuppression to include the mTOR inhibitor sirolimus. Differential diagnosis included direct medication side effect, infection, and neoplasia.

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“…However, intratracheal masses can occur and have presented fatally. 46,49 Excisional biopsy of the lesion is the preferred management of an intraluminal laryngotracheal mass suspected of representing PTLD. Extraluminal masses (lymph nodes) should be excised if easily accessible or biopsied if not.…”

Section: Discussionmentioning

confidence: 99%

“…Laryngotracheal involvement in PTLD predominately presents in children with signs and symptoms of airway obstruction, ranging from sleep apnea to critical obstruction in a stridulous child, with cough or voice changes. [46][47][48][49] In children presenting posttransplant with obstructive sleep apnea, chronic cough, and voice changes and without gross ATH (which is far more common), laryngotracheal PTLD should be considered. Flexible laryngoscopy should be performed to evaluate the larynx from the epiglottis to trachea if achievable.…”

Section: Laryngotrachealmentioning

confidence: 99%

Posttransplant Lymphoproliferative Disorder: Otolaryngological Manifestations and Management

Heyes

Northfelt

Lott

2017

Otolaryngol.--head neck surg.

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Objective Posttransplant lymphoproliferative disorder (PTLD) is a unifying term for a spectrum of lymphoid expansion entities brought about by immunosuppression and is strongly associated with Epstein-Barr virus (EBV). Otolaryngological findings tend to present early in the clinical course; therefore, disease awareness among otolaryngologists is of utmost importance. This review synthesizes the body of literature pertaining to PTLD involving the head and neck, summarizes contemporary management, and highlights areas for future research. Data Sources PubMed/Medline. Review Methods Primary literature search of the Medline database was performed for all titles published in the past 10 years pertaining to PTLD. The database search included PTLD combined with a collection of otolaryngological MeSH terms. Full manuscripts were reviewed based on relevance of their title and abstract. Selection into this review was according to clinical and scientific relevance. Conclusion Adenotonsillar focus is common in children in whom adenotonsillectomy may be diagnostic and prevents potentially morbid airway obstruction. Sinonasal PTLD may mimic fungal infection. Laryngotracheal involvement predominately presents in children with symptoms of airway obstruction. PTLD limited to the esophagus is rare. Oral PTLD is rare and phenotypically varied. Cutaneous presentation of PTLD is infrequent, yet one-third of cases affects the head and neck. PTLD may present as cervical lymphadenopathy. Implications for Practice PTLD consideration is vital when evaluating posttransplant patients. Children and EBV-seronegative patients should receive otolaryngological follow-up after transplant. PTLD treatment is multidisciplinary and typically led by lymphoma specialists. Formal partnerships between otolaryngologists and transplant centers may improve patient care and research quality.

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Recurrent Posttransplant Lymphoproliferative Disorder Involving the Larynx and Trachea: Case Report and Review of the Literature

Cited by 13 publications

References 16 publications

Airway inflammation and symptoms in children following liver and heart transplantation

Airway inflammation and symptoms in children following liver and heart transplantation

Airway plaque presenting after alteration of immunosuppression in a pediatric patient remote from heart transplantation

Posttransplant Lymphoproliferative Disorder: Otolaryngological Manifestations and Management

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