Inayat Faisal, Hassan Ghias Ul, Tayyab Ghias Un Nabi, Saif Muhammad Wasif
Allama Iqbal Medical College, Lahore, Pakistan (Faisal Inayat).
Ameer ud Din Medical College, Lahore, Pakistan (Ghias UI Hassan, Ghias Un Nabi Tayyab).
Ann Gastroenterol. 2018 Mar-Apr;31(2):248-251. doi: 10.20524/aog.2018.0226. Epub 2018 Jan 8.
Post-transplantation lymphoproliferative disorders (PTLDs) are lymphoid proliferations or lymphomas that are the second most common tumors in adult transplant recipients. Most cases of PTLD are attributed to Epstein-Barr virus, which induces B-cell proliferation and occurs in the setting of severe immunosuppression after solid organ or bone marrow transplantation. The disorder is seen in 1-3% of liver transplant recipients and has a variable presentation chronology. Herein, we chronicle a case of aggressive B-cell lymphoma (PTLD WHO class-3) presenting with isolated gastrointestinal involvement in an Epstein-Barr virus-negative patient with living-donor liver transplantation, 4 years after receiving the transplant. While typical symptoms may be elusive in the immunocompromised setting, clinicians should be vigilant for underlying PTLD with isolated gastrointestinal involvement. Prompt detection and characterization by endoscopic evaluation with biopsy should be particularly stressed in such patients.
移植后淋巴细胞增生性疾病（PTLD）是淋巴样增生或淋巴瘤，是成年移植受者中第二常见的肿瘤。大多数PTLD病例归因于爱泼斯坦-巴尔病毒，该病毒诱导B细胞增殖，发生在实体器官或骨髓移植后严重免疫抑制的情况下。这种疾病在1%至3%的肝移植受者中可见，其临床表现具有时间上的变异性。在此，我们记录了一例侵袭性B细胞淋巴瘤（PTLD WHO 3级）的病例，该病例表现为孤立性胃肠道受累，患者为接受活体供肝移植4年后的爱泼斯坦-巴尔病毒阴性患者。在免疫功能低下的情况下，典型症状可能难以捉摸，临床医生应警惕存在孤立性胃肠道受累的潜在PTLD。对于此类患者，应特别强调通过内镜评估加活检进行快速检测和特征描述。
