Department of Neurological Surgery, National Hospital Organization Okayama Medical Center, Okayama, Japan.
Department of Pathology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
World Neurosurg. 2018 Jun;114:230-234. doi: 10.1016/j.wneu.2018.03.153. Epub 2018 Mar 31.
Posttransplant lymphoproliferative disorder (PTLD) is a rare condition occurring after organ transplantation. PTLD comprises 4 subtypes, of which Hodgkin lymphoma (HL) type and HL-like type (currently included in polymorphic type) account for only about 1%-3% of cases. Primary central nervous system PTLD is also rare; most cases are Epstein-Barr virus-positive, B-cell PTLD. To our knowledge, no case of HL-like PTLD has been documented.
A 43-year-old woman who underwent kidney transplantation for IgA nephropathy 14 years previously presented to the emergency department with seizure. Gadolinium-enhanced T1-weighted magnetic resonance imaging showed a ring-enhancing mass in the left temporal lobe. Gross total removal of the tumor was performed, and pathologic examination revealed findings consistent with HL-like PTLD. The patient's immunosuppressants were subsequently reduced, and she received postoperative systemic therapy with rituximab and radiation therapy. Follow-up magnetic resonance imaging showed no signs of relapse.
This represents an extremely rare case of a patient with HL-like PTLD occurring as a primary central nervous system lesion.
移植后淋巴组织增生性疾病（PTLD）是器官移植后发生的一种罕见病症。PTLD 包括 4 种亚型，其中霍奇金淋巴瘤（HL）型和 HL 样型（目前归入多形性型）仅占约 1%-3%的病例。原发性中枢神经系统 PTLD 也很少见；大多数病例为 EBV 阳性、B 细胞 PTLD。据我们所知，尚无 HL 样 PTLD 的病例报告。
一名 43 岁女性，14 年前因 IgA 肾病行肾移植，因癫痫发作急诊就诊。钆增强 T1 加权磁共振成像显示左颞叶有一个环形增强肿块。行肿瘤全切除，病理检查结果符合 HL 样 PTLD。随后减少了患者的免疫抑制剂，并接受了利妥昔单抗和放疗的术后全身治疗。随访磁共振成像显示无复发迹象。
这是一例极为罕见的 HL 样 PTLD 患者，发生于原发性中枢神经系统病变。
