Vandjelovic Nathan D, Barth Patrick C, Dunn Stephen P, Chikwava Kudakwashe R, Shah Udayan K
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.
J Surg Case Rep. 2019 Apr 6;2019(4):rjz111. doi: 10.1093/jscr/rjz111. eCollection 2019 Apr.
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.
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。
