Posttransplantation lymphoproliferative disorder

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Organ transplant recipients are at risk for posttransplantation lymphoproliferative disorder (PTLD). Risk factors include immunosuppressive therapy and Epstein-Barr virus. Non-Hodgkin lymphoma represents up to 93% of lymphomas in PTLD patients. Early recognition of the disease is essential because spontaneous regression may occur after a decrease in the dosage or even complete cessation of immunosuppressive therapy or with antiviral therapy. The most common sites of involvement are lymph nodes and the gastrointestinal tract.

Diagnosis

The imaging findings are

• Common features of PTLD include lymph node enlargement, a focal bowel mass with wall thickening, and necrosis or focal hepatic lesions that are hypoechoic at US and hypoattenuating at CT.
• The most common appearance in the chest is multiple pulmonary nodules with or without mediastinal adenopathy.
• CT or MR imaging may demonstrate brain involvement wtih PTLD preferentially involving the periventricular white matter at one or more sites.

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