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Multifocal Hepatic Epstein-Barr Virus-Associated Smooth Muscle Tumor Mimicking Posttransplant Lymphoproliferative
Prashanth Srinivasan1, Srinivas Ananth Kumar, Harish Goyal
1Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Abstract:
Epstein-Barr virus-associated smooth muscle tumors (EBV-SMT) are rare neoplasms seen in immunocompromised patients and may mimic posttransplant lymphoproliferative disorder (PTLD). We report a 19-year-old renal transplant recipient presenting with abdominal symptoms and suspected PTLD. 18F-FDG PET/CT demonstrated multiple hypermetabolic liver lesions. Histopathology confirmed EBV-SMT. Follow-up PET/CT after immunosuppression with mTOR inhibition demonstrated partial metabolic response. This case highlights the role of 18F-FDG PET/CT in detecting multifocal disease, guiding biopsy, differentiating from PTLD, and assessing treatment response in EBV-SMT.
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