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Post-transplant lymphoproliferative disorder presenting as epistaxis
Jonathan D Clarke1, David Stock, Vijay Singh
1Department of Otolaryngology, Royal Glamorgan Hospital, Llantrisant, Wales, UK. jonathan@clarke5143.freeserve.co.uk
The Journal of Laryngology and Otology
|January 11, 2005
Summary
Epistaxis (nosebleeds) can rarely signal post-transplant lymphoproliferative disorder (PTLD). This case highlights PTLD in the nasal cavity, a novel presentation requiring thorough examination of transplant patients with nosebleeds.
Area of Science:
- Oncology
- Transplantation Medicine
- Otolaryngology
Background:
- Post-transplant lymphoproliferative disorder (PTLD) is a known complication following organ transplantation.
- PTLD commonly affects the tonsils, particularly in pediatric patients.
Observation:
- A 30-year-old female renal transplant recipient presented with severe, unilateral posterior epistaxis.
- Imaging revealed a polypoid mass in the left post-nasal space (PNS), originating from the sphenoethmoidal recess.
Findings:
- Biopsy confirmed the mass as an Epstein-Barr virus-positive polymorphous B-cell PTLD.
- This represents the first reported case of PTLD in the PNS presenting as epistaxis.
Implications:
- Transplant recipients experiencing epistaxis warrant comprehensive evaluation of the PNS and nasal cavity.
- This case expands the differential diagnosis for epistaxis in immunocompromised patients.