A Case of Posttransplant Lymphoproliferative Disorder in the Duodenum after Kidney Transplantation.
- Author:
Jin Ho KWAK
1
;
Kyu Bok JIN
;
Jung Eun KIM
;
Eun Ah HWANG
;
Seung Yeup HAN
;
Sung Bae PARK
;
Hyun Chul KIM
Author Information
1. Department of Internal Medicine, Keimyung University School of Medicine Dongsan Kidney Institute, Daegu, Korea. sbpark@dsmc.or.kr
- Publication Type:Case Report
- Keywords:
Lymphoproliferative disorder;
Kidney transplantation;
Duodenum
- MeSH:
B-Lymphocytes;
Colon;
Diagnosis;
Duodenal Ulcer;
Duodenum*;
Endoscopy;
Endoscopy, Gastrointestinal;
Follow-Up Studies;
Herpesvirus 4, Human;
Hodgkin Disease;
Humans;
Hyperplasia;
Kidney Transplantation*;
Kidney*;
Lymphoma, B-Cell;
Lymphoproliferative Disorders*;
Middle Aged;
Organ Transplantation;
Sepsis;
Transplants;
Ulcer
- From:Korean Journal of Nephrology
2007;26(2):294-299
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Posttransplant lymphoproliferative disorder (PTLD) is an uncommon but life-threatening complication of immunosuppressive therapy following solid organ transplantation. It encompasses a heterogeneous group of lymphoproliferative disorders ranging from reactive, polyclonal hyperplasia to aggressive non- Hodgkin's lymphoma. The majority of PTLD is of B-cell origin and associated with Epstein-Barr virus (EBV) infection. Gastrointestinal involvement, especially small bowel and colon, is common in patients with PTLD, but the duodenum is rarely involved. We have experienced a case of PTLD involving the duodenum eight years after kidney transplantation in 50-year-old man. Two weeks before admission, he had complained of epigastric pain, and was diagnosed as pangastritis and duodenal ulcer by upper gastrointestinal endoscopy. He was admitted due to aggravated epigastric pain despite anti-ulcer medication. On the seventh hospital day, we found a new mass-like lesion in the pyloric area of antrum and diffuse ulceration in the duodenum by follow-up endoscopy. Histologic findings revealed diffuse large B-cell lymphoma. During reduction in immunosuppressive regimens, his conditions deteriorated rapidly. He died of sepsis associated with duodenal ulcer perforation, 18 days after diagnosis.
