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Posttransplantation Lymphoproliferative Disorder
Patricia A. Hudgins, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Posttransplantation lymphoproliferative disorder (PTLD)
              • Synonyms

                • Posttransplant lymphoproliferative disorder
              • Definitions

                • Uncontrolled lymphoid growth in transplant recipient on immunosuppressive therapy
                • Spectrum of disease: Hyperplasia to malignancy
                  • Reactive hyperplasia → polymorphic PTLD → monomorphic PTLD → HD & NHL-like PTLD

              IMAGING

              • General Features

                • Imaging Recommendations

                  • CT Findings

                    • MR Findings

                      • Nuclear Medicine Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            Selected References

                                            1. Rosenberg AS et al: Hodgkin lymphoma post-transplant lymphoproliferative disorder: a comparative analysis of clinical characteristics, prognosis, and survival. Am J Hematol. 91(6):560-5, 2016
                                            2. Akbas A et al: Post-transplant lymphoproliferative disorders with naso- and oropharyngeal manifestation. Transpl Int. 28(11):1299-307, 2015
                                            3. Camacho JC et al: Posttransplantation lymphoproliferative disease: proposed imaging classification. Radiographics. 34(7):2025-38, 2014
                                            4. Banks CA et al: Recurrent posttransplant lymphoproliferative disorder involving the larynx and trachea: case report and review of the literature. Ann Otol Rhinol Laryngol. 121(5):291-5, 2012
                                            5. Hatten KM et al: Isolated sinonasal posttransplantation lymphoproliferative disorder: a clinical and radiographic invasive fungal sinusitis look-a-like. ORL J Otorhinolaryngol Relat Spec. 74(6):339-42, 2012
                                            6. Borhani AA et al: Imaging of posttransplantation lymphoproliferative disorder after solid organ transplantation. Radiographics. 29(4):981-1000; discussion 1000-2, 2009
                                            7. Knight JS et al: Lymphoma after solid organ transplantation: risk, response to therapy, and survival at a transplantation center. J Clin Oncol. 27(20):3354-62, 2009
                                            8. Carbone A et al: EBV-associated lymphoproliferative disorders: classification and treatment. Oncologist. 13(5):577-85, 2008
                                            9. Johnston PB et al: Positron emission tomography using F-18 fluorodeoxyglucose pre- and post-autologous stem cell transplant in non-Hodgkin's lymphoma. Bone Marrow Transplant. 41(11):919-25, 2008
                                            10. Ojha J et al: Post-transplant lymphoproliferative disorders of oral cavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 105(5):589-96, 2008
                                            11. Zafar SY et al: Malignancy after solid organ transplantation: an overview. Oncologist. 13(7):769-78, 2008
                                            12. Bakker NA et al: Presentation and early detection of post-transplant lymphoproliferative disorder after solid organ transplantation. Transpl Int. 20(3):207-18, 2007
                                            13. Campisi P et al: Utility of head and neck biopsies in the evaluation of posttransplant lymphoproliferative disorder. Otolaryngol Head Neck Surg. 137(2):296-300, 2007
                                            14. Jamali FR et al: An overview of the pathogenesis and natural history of post-transplant T-cell lymphoma. Leuk Lymphoma. 2007 Jun;48(6):1237-41. Review. Erratum in: Leuk Lymphoma. 2007 Sep;48(9):1884. Corrected and republished in: Leuk Lymphoma. 48(9):1780-4, 2007
                                            15. Herrmann BW et al: Otolaryngological manifestations of posttransplant lymphoproliferative disorder in pediatric thoracic transplant patients. Int J Pediatr Otorhinolaryngol. 70(2):303-10, 2006
                                            16. Marsot-Dupuch K et al: Head and neck lesions in the immunocompromised host. Eur Radiol. 14 Suppl 3:E155-67, 2004
                                            17. Gordon AR et al: Posttransplantation lymphoproliferative disorder of the paranasal sinuses mimicking invasive fungal sinusitis: case report. AJNR Am J Neuroradiol. 23(5):855-7, 2002
                                            18. Vargas H et al: Posttransplant lymphoproliferative disorder of the nasopharynx. Am J Rhinol. 16(1):37-42, 2002
                                            19. Shapiro NL et al: Adenotonsillar hypertrophy and Epstein-Barr virus in pediatric organ transplant recipients. Laryngoscope. 111(6):997-1001, 2001
                                            20. Williamson RA et al: Adenotonsillar histopathology after organ transplantation. Otolaryngol Head Neck Surg. 125(3):231-40, 2001
                                            21. Hopwood P et al: The role of EBV in post-transplant malignancies: a review. J Clin Pathol. 53(4):248-54, 2000
                                            22. Loevner LA et al: Posttransplantation lymphoproliferative disorder of the head and neck: imaging features in seven adults. Radiology. 216(2):363-9, 2000
                                            23. Raut A et al: Unusual gingival presentation of post-transplantation lymphoproliferative disorder: a case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 90(4):436-41, 2000
                                            24. Lattyak BV et al: Posttransplant lymphoproliferative disorder presenting in the head and neck. Laryngoscope. 108(8 Pt 1):1195-8, 1998
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Posttransplantation lymphoproliferative disorder (PTLD)
                                                        • Synonyms

                                                          • Posttransplant lymphoproliferative disorder
                                                        • Definitions

                                                          • Uncontrolled lymphoid growth in transplant recipient on immunosuppressive therapy
                                                          • Spectrum of disease: Hyperplasia to malignancy
                                                            • Reactive hyperplasia → polymorphic PTLD → monomorphic PTLD → HD & NHL-like PTLD

                                                        IMAGING

                                                        • General Features

                                                          • Imaging Recommendations

                                                            • CT Findings

                                                              • MR Findings

                                                                • Nuclear Medicine Findings

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Consider

                                                                                      Selected References

                                                                                      1. Rosenberg AS et al: Hodgkin lymphoma post-transplant lymphoproliferative disorder: a comparative analysis of clinical characteristics, prognosis, and survival. Am J Hematol. 91(6):560-5, 2016
                                                                                      2. Akbas A et al: Post-transplant lymphoproliferative disorders with naso- and oropharyngeal manifestation. Transpl Int. 28(11):1299-307, 2015
                                                                                      3. Camacho JC et al: Posttransplantation lymphoproliferative disease: proposed imaging classification. Radiographics. 34(7):2025-38, 2014
                                                                                      4. Banks CA et al: Recurrent posttransplant lymphoproliferative disorder involving the larynx and trachea: case report and review of the literature. Ann Otol Rhinol Laryngol. 121(5):291-5, 2012
                                                                                      5. Hatten KM et al: Isolated sinonasal posttransplantation lymphoproliferative disorder: a clinical and radiographic invasive fungal sinusitis look-a-like. ORL J Otorhinolaryngol Relat Spec. 74(6):339-42, 2012
                                                                                      6. Borhani AA et al: Imaging of posttransplantation lymphoproliferative disorder after solid organ transplantation. Radiographics. 29(4):981-1000; discussion 1000-2, 2009
                                                                                      7. Knight JS et al: Lymphoma after solid organ transplantation: risk, response to therapy, and survival at a transplantation center. J Clin Oncol. 27(20):3354-62, 2009
                                                                                      8. Carbone A et al: EBV-associated lymphoproliferative disorders: classification and treatment. Oncologist. 13(5):577-85, 2008
                                                                                      9. Johnston PB et al: Positron emission tomography using F-18 fluorodeoxyglucose pre- and post-autologous stem cell transplant in non-Hodgkin's lymphoma. Bone Marrow Transplant. 41(11):919-25, 2008
                                                                                      10. Ojha J et al: Post-transplant lymphoproliferative disorders of oral cavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 105(5):589-96, 2008
                                                                                      11. Zafar SY et al: Malignancy after solid organ transplantation: an overview. Oncologist. 13(7):769-78, 2008
                                                                                      12. Bakker NA et al: Presentation and early detection of post-transplant lymphoproliferative disorder after solid organ transplantation. Transpl Int. 20(3):207-18, 2007
                                                                                      13. Campisi P et al: Utility of head and neck biopsies in the evaluation of posttransplant lymphoproliferative disorder. Otolaryngol Head Neck Surg. 137(2):296-300, 2007
                                                                                      14. Jamali FR et al: An overview of the pathogenesis and natural history of post-transplant T-cell lymphoma. Leuk Lymphoma. 2007 Jun;48(6):1237-41. Review. Erratum in: Leuk Lymphoma. 2007 Sep;48(9):1884. Corrected and republished in: Leuk Lymphoma. 48(9):1780-4, 2007
                                                                                      15. Herrmann BW et al: Otolaryngological manifestations of posttransplant lymphoproliferative disorder in pediatric thoracic transplant patients. Int J Pediatr Otorhinolaryngol. 70(2):303-10, 2006
                                                                                      16. Marsot-Dupuch K et al: Head and neck lesions in the immunocompromised host. Eur Radiol. 14 Suppl 3:E155-67, 2004
                                                                                      17. Gordon AR et al: Posttransplantation lymphoproliferative disorder of the paranasal sinuses mimicking invasive fungal sinusitis: case report. AJNR Am J Neuroradiol. 23(5):855-7, 2002
                                                                                      18. Vargas H et al: Posttransplant lymphoproliferative disorder of the nasopharynx. Am J Rhinol. 16(1):37-42, 2002
                                                                                      19. Shapiro NL et al: Adenotonsillar hypertrophy and Epstein-Barr virus in pediatric organ transplant recipients. Laryngoscope. 111(6):997-1001, 2001
                                                                                      20. Williamson RA et al: Adenotonsillar histopathology after organ transplantation. Otolaryngol Head Neck Surg. 125(3):231-40, 2001
                                                                                      21. Hopwood P et al: The role of EBV in post-transplant malignancies: a review. J Clin Pathol. 53(4):248-54, 2000
                                                                                      22. Loevner LA et al: Posttransplantation lymphoproliferative disorder of the head and neck: imaging features in seven adults. Radiology. 216(2):363-9, 2000
                                                                                      23. Raut A et al: Unusual gingival presentation of post-transplantation lymphoproliferative disorder: a case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 90(4):436-41, 2000
                                                                                      24. Lattyak BV et al: Posttransplant lymphoproliferative disorder presenting in the head and neck. Laryngoscope. 108(8 Pt 1):1195-8, 1998