Hungarian Radiology

[Abdominal and thoracal manifestations of posttransplantation lymphoproliferative disorder in children]

VÁRKONYI Ildikó1, NYITRAI Anna1, MAGYAROSY Edina2, RÉNYI Imre2, SZEBERÉNYI Júlia1, KIS Éva1

DECEMBER 20, 2007

Hungarian Radiology - 2007;81(07-08)

[INTRODUCTION - Posttransplantation lymphoproliferative disorder is a secondary disease of transplanted patients, usually with good response to reduction of immunsuppressive therapy. PATIENTS AND METHODS - The lymphoproliferative disorder was diagnosed in four children among 139, renal, liver and lung transplanted patients. Clinical data (original disease, transplanted organ, age and time elapsed since transplantation at the diagnosis of the disorder) and imaging findings (chest X-ray, thoracal and abdominal computed tomography scans) were analysed retrospectively. RESULTS - Thoracal and abdominal forms were the most frequent manifestations of posttransplantation lymphoproliferative disorder in our patients. Following features have been diagnosed on imaging studies: multiple liver nodules (two cases), multiple nodules in the renal parenchyma (two cases), splenomegaly (two cases), bowel wall thickening (two cases). Retroperitoneal and mesenteric lymph node enlargement was found in all patients. Thoracal manifestations were as follows: mediastinal lymphadenopathy (two cases), hilar mass (one case), multiple pulmonary nodules (one case). Renal rupture with perirenal hematoma in one case, hilar mass envolving the main bronchus in one case, hepatic abscesses necessitating drainage in one case, and bowel wall necrosis in one case were the complications of posttransplantation lymphoproliferative disorder. CONCLUSION - Presenting symptoms are aspecific, often mimicking infection. Posttransplantation lymphoproliferative disorder has to be excluded if aspecific symptoms in a transplanted patient are present, or the patient does not react properly on antibiotics. First step investigations include chest X-ray and abdominal sonography. Neck, chest and abdominal CT are mandatory for detecting all manifestations, for staging the disease and to determine the best localization of obligatory biopsy.]

AFFILIATIONS

  1. Semmelweis Egyetem, I. Sz. Gyermekgyógyászati Klinika, Budapest
  2. Semmelweis Egyetem, II. Sz. Gyermekgyógyászati Klinika, Budapest

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