Imaging of post-transplant spindle cell tumors

Spindle/smooth muscle cell proliferation is an additional neoplastic process related to immunosuppression and EBV infection. We describe four post transplant children with this diagnosis. Multiple organ systems may be involved, particularly the liver, gastrointestinal tract, and lungs. Lesions are radiographically, clinically, and endoscopically indistinguishable from those of post-transplant lymphoproliferative disease (PTLD).