Lal H, Yadav P, Dey M, Kumar N
Department of Radiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Indian J Nephrol. 2017 May-Jun;27(3):218-221. doi: 10.4103/0971-4065.200519.
Transplant recipients are vulnerable to a horde of infections and neoplastic conditions due to immunosuppression. Posttransplant lymphoproliferative disorder (PTLD) is a condition unique to the transplant recipient occurring due to monoclonal lymphocytic proliferation. It may affect any organ system with reportedly highest incidence in the gastrointestinal tract. The incidence of adenocarcinoma of the colon, however, has not been shown to be uniformly higher in transplant recipients. We report here an unusual case of adenocarcinoma of the ascending colon presenting with liver, lymph node and skin metastasis in a transplant recipient, which simulated PTLD both clinically and radiologically. For any gastrointestinal lesion in transplant recipient, the possibility of carcinoma must be considered. However, a high index of suspicion for PTLD facilitates early diagnosis since the treatment of the two conditions is starkly different.
由于免疫抑制，移植受者易受多种感染和肿瘤性疾病的影响。移植后淋巴增殖性疾病（PTLD）是移植受者特有的一种疾病，由单克隆淋巴细胞增殖引起。它可累及任何器官系统，据报道在胃肠道的发病率最高。然而，结肠腺癌的发病率在移植受者中并未显示出普遍更高。我们在此报告一例升结肠癌的罕见病例，该病例在一名移植受者中出现肝脏、淋巴结和皮肤转移，在临床和放射学上均类似于PTLD。对于移植受者的任何胃肠道病变，必须考虑癌的可能性。然而，对PTLD高度怀疑有助于早期诊断，因为这两种疾病的治疗截然不同。
