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喉移植后淋巴组织增生性疾病

Post-transplant lymphoproliferative disease of the larynx.

作者信息

Vandjelovic Nathan D, Barth Patrick C, Dunn Stephen P, Chikwava Kudakwashe R, Shah Udayan K

机构信息

Division of Pediatric Otolaryngology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA.

Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

出版信息

J Surg Case Rep. 2019 Apr 6;2019(4):rjz111. doi: 10.1093/jscr/rjz111. eCollection 2019 Apr.

Abstract

Laryngeal post-transplant lymphoproliferative disease (PTLD) is rare. Here, we describe two pediatric cases. The first, a 15-month-old who underwent liver transplantation at 5 weeks, presented with airway distress. Airway evaluation identified epiglottic and arytenoid infiltrate, and biopsy was consistent with polymorphic PTLD. The second, a 23-month-old who underwent liver transplantation at 13 months, presented with progressive stridor. Airway evaluation revealed sub-mucosal infiltrate of the epiglottis, arytenoids, post-cricoid region, and uvula. Biopsy was consistent with monomorphic PTLD. Airway findings and symptoms resolved for both after immunosuppression reduction. PTLD diagnosis requires a high index of suspicion in post-transplant patients with airway obstruction.

摘要

喉移植后淋巴组织增生性疾病(PTLD)较为罕见。在此,我们描述两例儿科病例。第一例是一名15个月大的患儿,5周时接受了肝移植,出现气道窘迫。气道评估发现会厌和杓状软骨浸润,活检结果符合多形性PTLD。第二例是一名23个月大的患儿,13个月时接受了肝移植,出现进行性喘鸣。气道评估显示会厌、杓状软骨、环状软骨后区域和悬雍垂的粘膜下浸润。活检结果符合单形性PTLD。两例患儿在免疫抑制降低后气道表现和症状均得到缓解。对于有气道梗阻的移植后患者,PTLD诊断需要高度怀疑指数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15c3/6451186/b1de864777ad/rjz111f01.jpg

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