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器官移植受者恶性肿瘤的临床和放射学特征:环孢素治疗组与未治疗组患者对比

Clinical and radiologic features of malignant neoplasms in organ transplant recipients: cyclosporine-treated vs untreated patients.

作者信息

Honda H, Barloon T J, Franken E A, Garneau R A, Smith J L

机构信息

Department of Radiology, Kyushu University Faculty of Medicine, Fukuoka, Japan.

出版信息

AJR Am J Roentgenol. 1990 Feb;154(2):271-4. doi: 10.2214/ajr.154.2.2105012.

Abstract

The radiologic and clinical features of 37 posttransplantation malignant tumors occurring in 33 organ transplant recipients were reviewed to determine the characteristics of the tumors, particularly in relation to previous treatment (or nontreatment) with cyclosporine. The 37 malignant tumors included lymphomas (eight in patients receiving cyclosporine and four in patients not given cyclosporine) and carcinomas of the skin and lips (11), head and neck (five), colon and rectum (three), uterus (two), vulva (two), lung (one), and urinary bladder (one). The neoplasms of the internal viscera and head and neck were relatively advanced when detected. The neoplasms of the skin, vulva, uterine cervix, and urinary bladder were low-grade malignant tumors. Most of the cyclosporine-induced malignant lesions were lymphomas. The lymphomas in cyclosporine-treated recipients were characterized by early appearance after transplantation; more extensive organ involvement; multiple, homogeneous solid lesions without central low density on CT and sonography; and regression after reduction of cyclosporine dose. We conclude that malignant tumors occurring after transplantation are often advanced and that lymphoma induced by cyclosporine has characteristic features.

摘要

回顾了33例器官移植受者发生的37例移植后恶性肿瘤的放射学和临床特征,以确定这些肿瘤的特点,尤其是与先前使用环孢素治疗(或未治疗)的关系。这37例恶性肿瘤包括淋巴瘤(接受环孢素治疗的患者中有8例,未接受环孢素治疗的患者中有4例)以及皮肤和唇部癌(11例)、头颈癌(5例)、结肠直肠癌(3例)、子宫癌(2例)、外阴癌(2例)、肺癌(1例)和膀胱癌(1例)。内脏和头颈部位的肿瘤在被发现时相对处于晚期。皮肤、外阴、子宫颈和膀胱的肿瘤为低级别恶性肿瘤。大多数环孢素诱导的恶性病变是淋巴瘤。接受环孢素治疗的受者发生的淋巴瘤具有以下特点:移植后早期出现;器官受累范围更广;在CT和超声检查中表现为多个均匀的实性病变且无中央低密度区;在降低环孢素剂量后病情缓解。我们得出结论,移植后发生的恶性肿瘤往往处于晚期,并且环孢素诱导的淋巴瘤具有特征性表现。

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