Two cases of posttransplantation lymphoproliferative disorders in recipients of liver transplantation / 대한내과학회지

ABSTRACT

The posttransplantation lymphoproliferative disorders (PTLD) are not rare complications of solid organ transplants. The incidence varies with the type of transplantation and the nature and intensity of the immunosuppressive regimens. PTLDs are unique in that they have a predilection for extranodal sites, a strong and probably causal association with Ebstein-Barr virus infection, and a poor response to the cytolytic chemotherapeutic or irradiation regimens used for treatment of malignant lymphoma. The outcomes of treatment have been disappointing, with mortality from PTLD or related complications of over 50% of patients. We experienced two cases of PTLDs in liver transplant recipients presenting with liver mass and intraabdominal lymphadenopathy. PTLDs were diagnosed by autopsy and a liver biopsy. In the case diagnosed by a liver biopsy, EBV was detected by in situ hybridization. Despite reduction of immunosuppression and conservative management, both patients died.