Complete remission from post-heart transplant lymphoproliferative disorder: A case report.

We report a case of Burkitt's lymphoma, post-transplant lymphoproliferative disorder (BL-PTLD) that was treated with intensive chemotherapy. The patient was a 4-year-old boy who underwent heart transplantation at 7 months of age for refractory heart failure due to dilated cardiomyopathy. He was admitted to our hospital with a chief complaint of abdominal pain associated with an abdominal mass. Computed tomography was notable for a bulky mass arising from the terminal ileum. Fluorodeoxyglucose-positron emission tomography revealed multiple lesions in brain, bone, and lymph nodes. He was diagnosed with BL-PTLD stage III by pathological and clinical scoring. He was Epstein-Barr virus (EBV)-seronegative with a low EBV viral DNA load. No EBV-encoded small RNAs were in his intra-abdominal lymph nodes by in situ hybridization. On cytogenetic examination, the intra-abdominal lymph nodes revealed both a MYC rearrangement and a t(8;14)(q24;32), t(16;19)(q24;q13.1) translocation. Administration of tacrolimus and mycophenolate mofetil was discontinued; immunosuppression was maintained with everolimus. Intensive chemotherapy based on the modified LMB 96 protocol for BL was initiated, resulting in complete remission achieved. During the intensive chemotherapy and immunosuppressive switching period, cardiac dysfunction and allograft rejection had not been shown. The patient has remained well for two years after the treatment with no evidence of relapse. .

Investigation of the Section Thickness Measurement in Tomosynthesis by Thin Metal Plate Edge Method.

When performing tomosynthesis, the section thickness needs to be set depending on a radiographic part and its diagnostic purpose. However, the section thickness in tomosynthesis has not been clearly defined and its measurement method has not been established yet. In this study, we devised the alternative measurement method to diagnose the section thickness using an edge of thin metal plate, and compared with the simulation results, the wire and bead method reported in the previous papers. The tomographic image of the thin metal plate positioned on the table top inclining 30 degrees, which showed the edge spread function (ESF) of each tomographic height, was taken, and then the line spread function (LSF) was obtained by differentiating the ESF image. For the next, a profile curve was plotted by maximum values of LSF of each tomographic height, and a section thickness was calculated using the full width at half maximum (FWHM) of the profile curve. The edge method derived the section thickness close to the simulation results than the other methods. Further, the section thickness depends on the thickness of the metal plate and not the material. The thickness of the metal plate suitable for the evaluation of section thickness is 0.3 mm that is equivalent to pixel size of the flat panel detector (FPD). We conducted quantitative verification to establish the measurement method of the section thickness. The edge method is a useful technique as well as the wire and bead method for grasping basic characteristics of an imaging system.