Post-Transplant Lymphoproliferative Disorder: A Rare Case of CNS Involvement following Renal Transplant
Background: Post-transplant lymphoproliferative disorders (PTLD) are rare immunosuppression complications affecting 5% of transplant patients. Isolated central nervous system (CNS)-PTLD without nodal or extra-nodal organ involvement is rarely reported and is difficult to diagnose due to the non-spec...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-11-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/23/7058 |
| _version_ | 1797462962185699328 |
|---|---|
| author | Austin Feindt Montserrat Lara-Velazquez Ahmad Alkhasawneh Dinesh Rao Raafat Makary Keith Dombrowski Daryoush Tavanaiepour Gazanfar Rahmathulla |
| author_facet | Austin Feindt Montserrat Lara-Velazquez Ahmad Alkhasawneh Dinesh Rao Raafat Makary Keith Dombrowski Daryoush Tavanaiepour Gazanfar Rahmathulla |
| author_sort | Austin Feindt |
| collection | DOAJ |
| description | Background: Post-transplant lymphoproliferative disorders (PTLD) are rare immunosuppression complications affecting 5% of transplant patients. Isolated central nervous system (CNS)-PTLD without nodal or extra-nodal organ involvement is rarely reported and is difficult to diagnose due to the non-specific clinical manifestations and imaging features overlapping with other common CNS lesions. Case presentation: We present a case of a 72-year-old female subjected to a renal transplant 11 years ago with progressively worsening headaches and confusion. Imaging revealed vasogenic edema in the left frontal and bilateral temporal lobes. She was subjected to a craniotomy and excisional biopsy to obtain tissue for diagnostic and therapeutic interventions. Pathology examination showed atypical EBV-positive lymphoplasmacytic infiltrate, consistent with Polymorphic type PTLD. Conclusions: Patients diagnosed with PTLD need to have close monitoring of immunosuppressive medications while in the hospital. Early diagnosis is essential for patient survival with PTLD, as their health can deteriorate fast. |
| first_indexed | 2024-03-09T17:43:58Z |
| format | Article |
| id | doaj.art-cda288ae27194c278fa61148a873c3c7 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T17:43:58Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-cda288ae27194c278fa61148a873c3c72023-11-24T11:22:13ZengMDPI AGJournal of Clinical Medicine2077-03832022-11-011123705810.3390/jcm11237058Post-Transplant Lymphoproliferative Disorder: A Rare Case of CNS Involvement following Renal TransplantAustin Feindt0Montserrat Lara-Velazquez1Ahmad Alkhasawneh2Dinesh Rao3Raafat Makary4Keith Dombrowski5Daryoush Tavanaiepour6Gazanfar Rahmathulla7School of Medicine, University of South Florida School of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USADepartment of Neurological Surgery, University of Florida College of Medicine, 653-1 8th St. W, Jacksonville, FL 32209, USADepartment of Pathology, University of Florida College of Medicine, 8th St. W, Jacksonville, FL 32209, USADepartment of Radiology, University of Florida College of Medicine, 8th St. W, Jacksonville, FL 32209, USADepartment of Pathology, University of Florida College of Medicine, 8th St. W, Jacksonville, FL 32209, USADepartment of Neurosurgery and Brain Repair, USF Health, 2 Tampa General Cir, Tampa, FL 33606, USADepartment of Neurological Surgery, University of Florida College of Medicine, 653-1 8th St. W, Jacksonville, FL 32209, USADepartment of Neurological Surgery, University of Florida College of Medicine, 653-1 8th St. W, Jacksonville, FL 32209, USABackground: Post-transplant lymphoproliferative disorders (PTLD) are rare immunosuppression complications affecting 5% of transplant patients. Isolated central nervous system (CNS)-PTLD without nodal or extra-nodal organ involvement is rarely reported and is difficult to diagnose due to the non-specific clinical manifestations and imaging features overlapping with other common CNS lesions. Case presentation: We present a case of a 72-year-old female subjected to a renal transplant 11 years ago with progressively worsening headaches and confusion. Imaging revealed vasogenic edema in the left frontal and bilateral temporal lobes. She was subjected to a craniotomy and excisional biopsy to obtain tissue for diagnostic and therapeutic interventions. Pathology examination showed atypical EBV-positive lymphoplasmacytic infiltrate, consistent with Polymorphic type PTLD. Conclusions: Patients diagnosed with PTLD need to have close monitoring of immunosuppressive medications while in the hospital. Early diagnosis is essential for patient survival with PTLD, as their health can deteriorate fast.https://www.mdpi.com/2077-0383/11/23/7058lymphoproliferative disorderorgan transplantationEpstein–Barr virus infections |
| spellingShingle | Austin Feindt Montserrat Lara-Velazquez Ahmad Alkhasawneh Dinesh Rao Raafat Makary Keith Dombrowski Daryoush Tavanaiepour Gazanfar Rahmathulla Post-Transplant Lymphoproliferative Disorder: A Rare Case of CNS Involvement following Renal Transplant Journal of Clinical Medicine lymphoproliferative disorder organ transplantation Epstein–Barr virus infections |
| title | Post-Transplant Lymphoproliferative Disorder: A Rare Case of CNS Involvement following Renal Transplant |
| title_full | Post-Transplant Lymphoproliferative Disorder: A Rare Case of CNS Involvement following Renal Transplant |
| title_fullStr | Post-Transplant Lymphoproliferative Disorder: A Rare Case of CNS Involvement following Renal Transplant |
| title_full_unstemmed | Post-Transplant Lymphoproliferative Disorder: A Rare Case of CNS Involvement following Renal Transplant |
| title_short | Post-Transplant Lymphoproliferative Disorder: A Rare Case of CNS Involvement following Renal Transplant |
| title_sort | post transplant lymphoproliferative disorder a rare case of cns involvement following renal transplant |
| topic | lymphoproliferative disorder organ transplantation Epstein–Barr virus infections |
| url | https://www.mdpi.com/2077-0383/11/23/7058 |
| work_keys_str_mv | AT austinfeindt posttransplantlymphoproliferativedisorderararecaseofcnsinvolvementfollowingrenaltransplant AT montserratlaravelazquez posttransplantlymphoproliferativedisorderararecaseofcnsinvolvementfollowingrenaltransplant AT ahmadalkhasawneh posttransplantlymphoproliferativedisorderararecaseofcnsinvolvementfollowingrenaltransplant AT dineshrao posttransplantlymphoproliferativedisorderararecaseofcnsinvolvementfollowingrenaltransplant AT raafatmakary posttransplantlymphoproliferativedisorderararecaseofcnsinvolvementfollowingrenaltransplant AT keithdombrowski posttransplantlymphoproliferativedisorderararecaseofcnsinvolvementfollowingrenaltransplant AT daryoushtavanaiepour posttransplantlymphoproliferativedisorderararecaseofcnsinvolvementfollowingrenaltransplant AT gazanfarrahmathulla posttransplantlymphoproliferativedisorderararecaseofcnsinvolvementfollowingrenaltransplant |