Sculerati N, Arriaga M
Department of Otolaryngology, New York University Medical Center, NY 10016.
Ann Otol Rhinol Laryngol. 1990 Jun;99(6 Pt 1):445-50. doi: 10.1177/000348949009900606.
Twelve of 14 children (86%) given a pathologic diagnosis of posttransplantation lymphoproliferative disease (PTLD) at the Children's Hospital of Pittsburgh presented with head and neck symptoms, and are included in this retrospective analysis. Upper airway obstruction was the most common symptom, evident in nine children (75%). Ten children (83%) had febrile illnesses with dysphagia, odynophagia, and evidence of hypertrophy of components of Waldeyer's ring. Associated findings included cervical adenopathy, sinusitis, and otitis media. The two remaining children had an intratracheal and paratracheal mass, respectively. Excision of obstructing lymphoid tissue with proper handling of the specimen is advocated for diagnosis and relief of airway obstruction. Systemic therapy is necessary for treatment of PTLD and includes reduction of immunosuppression. Erythromycin causes elevation in cyclosporine levels and should be avoided in patients taking this drug.
匹兹堡儿童医院确诊为移植后淋巴组织增生性疾病（PTLD）的14名儿童中有12名（86%）出现头颈部症状，纳入本回顾性分析。上呼吸道梗阻是最常见症状，9名儿童（75%）有此症状。10名儿童（83%）有发热性疾病，伴有吞咽困难、吞咽痛及咽淋巴环各部分肥大的表现。相关表现包括颈部淋巴结病、鼻窦炎和中耳炎。其余两名儿童分别有气管内和气管旁肿物。主张切除阻塞性淋巴组织并妥善处理标本以进行诊断和缓解气道梗阻。PTLD的治疗需要全身治疗，包括减少免疫抑制。红霉素会使环孢素水平升高，服用该药的患者应避免使用。
