Chest
Clinical InvestigationsPosttransplant Lymphoproliferative Disorder: Incidence, Presentation, and Response to Treatment in Lung Transplant Recipients
Section snippets
Materials and Methods
We performed a retrospective review of all lung and heart-lung transplant recipients with a diagnosis of PTLD since the inception of our lung transplant program in 1992. Of a total of 400 lung or heart-lung transplant recipients who underwent transplantation from 1992 until July 1, 2002, 10 patients received a diagnosis of PTLD. The demographic information for these patients is shown in Table 1; the data were obtained by medical record review.
Patients who acquired PTLD received postoperative
Results
The most common indications for transplant in our population were as follows: COPD (50%), cystic fibrosis (25%), pulmonary fibrosis (14%), and sarcoidosis (5%). Demographic information, treatment regimens and outcomes are shown in Table 2. The mean (± SD) age of our patients with PTLD was 53.8 ± 15.4 years, and 80% were > 55 years old. In contrast, only 39% (152 of 390 transplant recipients) without PTLD were > 55 years old (p = 0.02, Fisher exact test). There was a trend toward more
Discussion
Our results demonstrate a low incidence of PTLD in a large cohort of lung transplant recipients. Patients with PTLD tended to be > 55 years old and with a native disease of COPD; PTLD in our population appeared unrelated to pretransplant EBV status or immunosuppressive regimen. Presentation with single or multiple nodules or masses in the thorax was most common, although extrapulmonary disease was seen in a few patients. Most patients had histologic evidence of monomorphic or polymorphic B-cell
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2019, Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyPosttransplant Lymphoproliferative Disorders in Epstein-Barr Virus Donor Positive/Recipient Negative Lung Transplant Recipients
2018, Annals of Thoracic SurgeryIncreased risk of PTLD in lung transplant recipients with cystic fibrosis
2017, Journal of Cystic FibrosisCitation Excerpt :The highest rates of PTLD occurred in lung transplant recipients who had CF and were EBV seronegative. In this investigation we found a relatively low prevalence of PTLD in both the CF and non-CF populations compared to previously reported studies [2,4–10]. The occurrence we observed in lung transplant recipients is more aligned with reported prevalence of PTLD in other solid organ transplants [3,11–13].
Imaging the Complications of Lung Transplantation
2016, Radiologic Clinics of North AmericaCitation Excerpt :The initial treatment of PTLD involves reduction in immunosuppression, which increases the risk of developing rejection. The most common imaging manifestations of PTLD are pulmonary nodules and masses (Fig. 15), which can be associated with lymphadenopathy and pleural effusions.83 Although most of these findings are recognizable on CXR, CT best characterizes these findings (see Fig. 15F).
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