Posttransplantation lymphoproliferative disorder with skin involvement

Area of Science:

• Oncology
• Transplantation Immunology
• Dermatology

Background:

• Posttransplantation lymphoproliferative disorders (PTLD) are a serious complication following solid organ and bone marrow transplantation.
• PTLD arises from the uncontrolled proliferation of lymphoid cells due to iatrogenic immunosuppression.
• Renal transplant recipients have a 1-2% incidence of PTLD, typically presenting within the first year post-transplant.

Observation:

• This report details a unique case of a renal transplant recipient.
• The patient developed a B-cell lymphoma, classified as PTLD WHO class-3.
• The PTLD manifested with significant skin involvement, a less common presentation.

Findings:

• The B-cell lymphoma presented 8 years after the renal transplantation.
• This delayed presentation is unusual, as PTLD commonly appears within the first year.
• Skin manifestation of PTLD in this case suggests a need for broader diagnostic considerations.

Implications:

• This case underscores the importance of considering PTLD even years after transplantation.
• Delayed PTLD presentations can manifest with diverse clinical features, including cutaneous involvement.
• Awareness of atypical PTLD timelines and presentations is crucial for timely diagnosis and management in transplant patients.