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Early Onset Polymorphic Post-transplant Lymphoproliferative Disease Mimicking a Solitary Necrotizing Abscess in a Graft Liver

대한간암학회지 2019년 19권 2호 p.165 ~ 170
 ( Sung Pil-Soo ) - Eunpyeong St. Mary‘s Hospital Department of Internal Medicine

이준 ( Lee Joon ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
 ( Nam Hee-Chul ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
 ( Bae Si-Hyun ) - Eunpyeong St. Mary‘s Hospital Department of Internal Medicine
 ( Yoon Seung-Kew ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine

Abstract


Although post-transplantation lymphoproliferative disease (PTLD) after liver transplantation is very rare, its prognosis is worse than that of PTLD following other types of solid organ transplantation. Here, we report a rare case of early onset polymorphic PTLD in a graft liver occurring five months after deceased-donor liver transplantation due to hepatocellular carcinoma and hepatitis C virus infection. Initially, findings from contrast-enhanced magnetic resonance imaging mistakenly suspected the lesion was a necrotizing abscess with central necrosis. However, 18F-fluorodeoxyglucose positron emission tomography and biopsy findings confirmed an Epstein-Barr virus (EBV)-associated, B cell type polymorphic PTLD with central necrosis. Our case suggests regular monitoring of EBV serologic status for liver transplant recipients who were initially in an EBV seronegative state. Although early-onset PTLD is very rare after liver transplantation, PTLD should be suspected when recipients show the seroconversion for EBV proteins and the development of new tumors with various clinical presentations.

키워드

Post-transplantation lymphoproliferative disease; Epstein-Barr virus; 18F-fluorodeoxyglucose positron emission tomography
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