IS Case 576: Posttransplantation lymphoproliferative disorder (PTLD)

Narasimhachar G. Prativadi, MD

Imaging Sciences URMC

Imaging Sciences URMC 2010
Publication Date: 2011-11-17

History

Patient is a 45-year-old male with history of renal transplant three years ago and now found to have multiple liver lesions on ultrasound.

Imaging findings include tumor involvement of the liver, abdominal lymph nodes, mesenteric lymph nodes, omentum, bowel, and transplanted kidney.

Post-transplantation lymphoproliferative disorder (PTLD) is a phenomenon seen in transplant patients. Chronic immunosuppression leads to uncontrolled expansion of lymphoid cells. The disease most often results from the Epstein Barr virus infection. The virus causes B-cell proliferation ranging from lymphoid hyperplasia to malignant proliferation. The abdomen is most commonly involved in PTLD. Liver involvement often appears as low attenuation lesions ranging between 1 and 4 cm. Splenic lesions are also hypoattenuating. The kidneys are also commonly involved. In the GI tract, the small bowel is the most frequently involved. Gi involvement often is seen as circumferential wall thickening of a segment of bowel.

Weissleder R, Wittenberg J, Harisinghani MG. Primer of Diagnostic Imaging. Philadelphia, PA: Mosby Elsevier, 2007.