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Lymphoproliferative disorders after lung transplantation: imaging features
D C Rappaport1, D W Chamberlain, F A Shepherd
1Department of Medical Imaging, Toronto Hospital, Ontario, Canada.
Radiology
|February 11, 1998
Summary
Post-transplant lymphoproliferative disorders in lung transplant recipients often present as multiple, well-defined pulmonary nodules. Prompt pathological evaluation is crucial for diagnosis and timely management of these conditions.
Area of Science:
- Thoracic imaging
- Transplant pathology
- Immunocompromised hosts
Background:
- Post-transplant lymphoproliferative disorders (PTLD) are a spectrum of lymphoid neoplasms occurring after solid organ transplantation.
- Lung transplant recipients are at increased risk for PTLD due to intense immunosuppression.
Purpose of the Study:
- To characterize the imaging features of PTLD in lung transplant recipients.
- To aid in the early detection and diagnosis of PTLD in this patient population.
Main Methods:
- Retrospective review of 246 lung transplant cases between 1987 and 1997.
- Analysis of imaging, clinical, and pathological findings in nine patients diagnosed with PTLD.
- Correlation of imaging findings with histopathological diagnoses.
Main Results:
- Eight of nine patients had isolated intrathoracic PTLD.
- The most frequent finding was multiple, well-defined pulmonary nodules, often with basilar and peripheral predominance.
- Other findings included adenopathy, consolidation, pleural mass, and abdominal lymphadenopathy; halo sign was present in three patients.
Conclusions:
- Well-defined pulmonary nodules in lung transplant recipients should raise suspicion for PTLD.
- Expedited pathological studies are recommended when PTLD is suspected based on imaging findings.