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Posttransplantation Lymphoproliferative Disorder in Pediatric Recipients of Solid Organ Transplants: Timing and Location of Disease

¹ Present address: Department of Radiology, Christiana Hospital, 4755 Ogletown-Stanton Rd., Newark, DE 19713.
² Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA.
³ Present address: Department of Pediatrics, Vanderbilt Children's Hospital, Nashville, TN.

View larger version (4K): [in a new window]   Fig. 1 —Bar graph shows time to onset of posttransplantation lymphoproliferative disorder (PTLD) according to transplant type. Almost all lung recipients presented with PTLD in first 20 months after transplantation.

View larger version (87K): [in a new window]   Fig. 2 —19-year-old woman (patient 23 in Table 1) after bilateral lung transplantation who presented with shortness of breath. CT scan shows conglomerate lymphadenopathy (arrow) extends from right lower neck into superior and middle mediastinum with numerous rim-enhancing fluid collections.

View larger version (101K): [in a new window]   Fig. 3 —22-year-old woman (patient 8 in Table 1) presented 5 years after cardiac transplant with abdominal pain and multiple masses in chest, abdomen, and pelvis. On CT scan, conglomerate of masses (arrows) was noted involving omentum, mesentery, and jejunum. Marked wall thickening and dilatation of proximal jejunum were verified at autopsy to be positive for posttransplantation lymphoproliferative disorder.

View larger version (117K): [in a new window]   Fig. 4A —11-year-old boy (patient 28 in Table 1; age 10 at diagnosis) after renal transplant removal who presented with chronic fevers and was evaluated on CT. Image shows large retrocrural soft-tissue mass (arrows) extends into retroperitoneum, anteriorly displacing and encasing aorta, celiac axis, and proximal superior mesenteric artery to above level of aortic bifurcation.

View larger version (97K): [in a new window]   Fig. 4B —11-year-old boy (patient 28 in Table 1; age 10 at diagnosis) after renal transplant removal who presented with chronic fevers and was evaluated on CT. Image shows that additional soft-tissue mass (arrows) involves iliopsoas muscle and extends into left pelvic sidewall, encasing internal and external iliac vessels.

View larger version (87K): [in a new window]   Fig. 5 —15-year-old girl (patient 6 in Table 1; age 14 at diagnosis) after heart transplant who presented with acute fever and mediastinal mass on conventional radiography. CT scan shows extensive supraclavicular adenopathy (arrow). Biopsy of mass was positive for polymorphous posttransplantation lymphoproliferative disorder.

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