Sterile necrotizing and non-necrotizing granulomas in a heart transplant patient with history of PTLD: A unique finding.
Case report
General surgery
Pediatric surgery
Posttransplant lymphoproliferative disease
Transplant surgery
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
2019
2019
Historique:
received:
11
04
2019
revised:
07
05
2019
accepted:
27
05
2019
pubmed:
12
6
2019
medline:
12
6
2019
entrez:
12
6
2019
Statut:
ppublish
Résumé
Posttransplant lymphoproliferative disease (PTLD) is a known complication in patients with solid organ transplant. It can present as localized or disseminated tumor. The cornerstone of management consists of reduced immunosuppression (RI). In select cases, localized disease can potentially be curative with surgical excision. Here we present a case of a 19-year-old female with orthotopic heart transplant with two episodes of recurrent PTLD. After the second episode she was found to have asymptomatic splenic lesions which were refractory to RI and chemotherapy. She subsequently underwent splenectomy that showed sterile necrotizing and non-necrotizing granulomas with no evidence of PTLD. Based on our literature search this is the first ever reported case of sterile granulomas in a patient with recurrent PTLD which could potentially be diagnosed with minimally invasive biopsy rather than diagnostic splenectomy. This report is an attempt to create awareness regarding potential for presence of sterile granulomas in patients with recurrent PTLD and discuss the use of percutaneous biopsy before splenectomy.
Identifiants
pubmed: 31185455
pii: S2210-2612(19)30301-3
doi: 10.1016/j.ijscr.2019.05.054
pmc: PMC6556822
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
8-12Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.
Références
Am J Surg Pathol. 2000 Mar;24(3):375-85
pubmed: 10716151
Transplantation. 2001 Apr 27;71(8):1076-88
pubmed: 11374406
Am J Transplant. 2004 Feb;4(2):222-30
pubmed: 14974943
J Cutan Pathol. 2004 May;31(5):353-61
pubmed: 15059219
Leuk Lymphoma. 2005 Feb;46(2):191-6
pubmed: 15621801
J Clin Oncol. 2005 Oct 20;23(30):7574-82
pubmed: 16186599
Transplantation. 2005 Nov 15;80(9):1233-43
pubmed: 16314791
Am J Transplant. 2006 Mar;6(3):569-76
pubmed: 16468968
Am J Transplant. 2006 Aug;6(8):1906-12
pubmed: 16889546
Haematologica. 2007 Feb;92(2):273-4
pubmed: 17296588
J Cutan Pathol. 2007 May;34(5):392-6
pubmed: 17448194
Leuk Lymphoma. 2008 Sep;49(9):1738-44
pubmed: 18798108
J Clin Oncol. 2009 Jul 10;27(20):3354-62
pubmed: 19451438
Am J Transplant. 2009 Dec;9 Suppl 4:S87-96
pubmed: 20070701
J Clin Oncol. 2010 Feb 20;28(6):1038-46
pubmed: 20085936
Am J Transplant. 2011 Feb;11(2):336-47
pubmed: 21219573
Radiology. 2011 Sep;260(3):699-708
pubmed: 21693659
Mod Pathol. 2012 Jan;25 Suppl 1:S31-8
pubmed: 22214968
Curr Treat Options Oncol. 2012 Mar;13(1):122-36
pubmed: 22241590
Am J Transplant. 2013 Feb;13 Suppl 3:41-54; quiz 54
pubmed: 23347213
Curr Hematol Malig Rep. 2013 Sep;8(3):173-83
pubmed: 23737188
Turk J Haematol. 2014 Mar;31(1):79-83
pubmed: 24764734
Curr Top Pathol. 1989;79:151-67
pubmed: 2644083
Int J Surg. 2018 Dec;60:132-136
pubmed: 30342279
Prog Allergy. 1978;24:183-267
pubmed: 351629
Am J Surg Pathol. 1980 Feb;4(1):13-28
pubmed: 7361992
Blood. 1995 Nov 1;86(9):3333-40
pubmed: 7579436
Hum Pathol. 1995 May;26(5):525-30
pubmed: 7750936
J Clin Oncol. 1998 Jun;16(6):2052-9
pubmed: 9626203