Chest
Selected ReportsThoracic Presentations of Posttransplant Lymphoproliferative Disorders
Section snippets
Materials and Methods
We retrospectively reviewed the medical records from the Department of Anatomic Pathology at Emory University Hospital for cases of PTLD using the keywords “lymphoma,” “malignancy,” and “PTLD.” In addition, transplant coordinators from each respective organ-specific program were contacted for information about patients who developed PTLDs or other malignancies between January 1990 and December 2001. Information collected from our databases was correlated with that from the United Network for
Presentation and Diagnosis
Patients with thoracic PTLDs included eight men and three women with a mean age of 49 years (age range, 19 to 61 years). The median time interval from transplantation to diagnosis of a thoracic PTLD was 8 months, with a range of 1 to 97 months (Table 2). Patients receiving heart, lung, or bone marrow transplants had a median time to presentation of 5 months (range, 1 to 14 months), compared to 75 months (range, 5 to 97 months) for the kidney and kidney/pancreas transplant patients. The
Discussion
Chronic rejection and opportunistic infections are the major obstacles that limit the success of solid-organ and bone marrow transplantation. The development of novel prevention strategies and highly specific immunosuppression regimens may reduce the incidence of these complications. PTLD is a rare complication that develops in transplant patients. This potentially lethal lymphoproliferative process is causally related to several factors, including the type of transplanted allograft,
ACKNOWLEDGMENT
We would like to acknowledge the following individuals for assisting with data collection and providing access to transplant databases: E. Clinton Lawrence, MD; Thomas C. Pearson, MD, PhD; J. David Vega, MD; Amelia A. Langston, MD; Thomas G. Heffron, MD; Seth D. Force, MD; Corby D’Amico, RN, MN; Richard Milam, RHIA, CPC; and Helen Triemer, PharmD, BCPS.
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Lymphoproliferative lung disorders: A radiologic-pathologic overview. part ii: Neoplastic disorders
2013, Seminars in Ultrasound, CT and MRICitation Excerpt :The incidence of PTLD in patients who undergo lung and heart-lung transplantation is 4%-10%.71 However, lung involvement by PTLD may occur regardless of the organ transplanted.72 The etiology of PTLD has been associated to a number of factors, including EBV infection, the type of transplanted allograft, intensity of immunosuppression (in particular, the use of cyclosporine and antilymphocyte antibodies), cytomegalovirus recipient-donor mismatch, and the incidence and frequency of acute rejection episodes.73,74
Lung Transplant Complications
2012, Emergency Medicine: Clinical Essentials, SECOND EDITIONIntermediate and Late Complications of Lung Transplantation
2010, Medical Management of the Thoracic Surgery PatientIntermediate and Late Complications of Lung Transplantation
2009, Medical Management of the Thoracic Surgery PatientExtranodal lymphoma in the thorax: cross-sectional imaging findings
2009, Clinical RadiologyCitation Excerpt :The geographic pulmonary changes and relevant history of radiation therapy allow the diagnosis of radiation pneumonitis. The most common thoracic manifestation of extranodal lymphoma in ARL and PTLD are multiple, bilateral, circumscribed nodules or masses without cavitation.4,21–24 The pulmonary nodules in ARL tend to be more circumscribed and less likely to occur in a peribronchovascular distribution in contrast to Kaposi's sarcoma.23