The Spectrum of Imaging Manifestations in Posttransplantation Lymphoproliferative Disease_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 QUYa-li , WUMing-peng , CHENChen-yang , WANGQi-yan , CHENJie , HUANGZi-xing , YUANFang ,  SONGBin

Department of Radiology, West China Hospital, Sichuan University. Chengdu 610041, Sichuan Province, China;

Corresponding author：

SONGBin, Email: cjr.songbin@vip.163.com

Keywords：

Posttransplantation lymphoproliferative disease; Immunosuppressive therapy; Epstein-Barr virus; Imaging manifestations

DOI：

10.7507/1007-9424.20150129

Video：

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Objective To explore the imaging manifestations of posttransplantation lymphoproliferative disease (PTLD) for making a further understanding of this disease and its imaging diagnosis. Methods By the method of litera-ture review, the imaging manifestations of PTLD in the abdomen, thorax, head and neck, and central nervous system were summarized, respectively, and also the epidemiologic features, pathogenesis and pathologic classification were reviewed. Results PTLD is a spectrum of lymphoproliferative diseases following transplantation mainly caused by Epstein-Barr virus and immunosuppressive therapy with different pathologic types.Lesions at imaging examinations may be the first clue to diagnose, and the appearance of PTLD at imaging can vary depending on the region. Conclusion Improving the cognition of PTLD and the imaging features plays a pivotal role in identifying the presence of disease, guiding tissue sampling, and evaluating response to treatment.

Citation： QUYa-li, WUMing-peng, CHENChen-yang, WANGQi-yan, CHENJie, HUANGZi-xing, YUANFang, SONGBin. The Spectrum of Imaging Manifestations in Posttransplantation Lymphoproliferative Disease. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(4): 490-493. doi: 10.7507/1007-9424.20150129 Copy

1.	Penn I.Post-transplant malignancy:the role of im-munosuppression.Drug Saf, 2000, 23(2):101-113.
2.	Engels EA, Pfeiffer RM, Fraumeni JF Jr, et al.Spec-trum of cancer risk among US solid organ transplant recipients.JAMA, 2011, 306(17):1891-1901.
3.	Babcock GJ, Decker LL, Freeman RB, et al.Epstein-Barr virus-infected resting memory B cells, not proliferating lymphoblasts, accumulate in the peripheral blood of immunosup-pressed patients.J Exp Med, 1999, 190(4):567-576.
4.	Choquet S, Varnous S, Deback C, et al.Adapted treatment of Eps-tein-Barr virus infection to prevent posttransplant lymphoprolifera-tive disorder after heart transplantation.Am J Transplant, 2014, 14(4), 857-886.
5.	Scarsbrook AF, Warakaulle DR, Dattani M, et al.Post-transplan-tation lymphoproliferative disorder:the spectrum of imaging appearances.Clin Radiol, 2005, 60(1):47-55.
6.	Végso G, Hajdu M, Sebestyén A.Lymphoprolifera-tive disorders after solid organ transplantati-on:clas-sification, incidence, risk factors, early detection and treatment options.Pathol Oncol Res, 2011, 17(3):443-454.
7.	Quinlan SC, Pfeiffer RM, Morton LM, et al.Risk factors for early-onset and late-onset post-transplant lymphoproliferative disorder in kidney recipients in the United States.Am J Hematol, 2011, 86(2):206-209.
8.	Penn I, Hammond W, Brettschneider L, et al.Malignant lymphoma in transplantation patients.Transplant Proc, 1969, 1:106-112.
9.	Mendizabal M, Marciano S, Silva M, et al.Post-transplant lympho-proliferative disorder in adult liver transplant recipients:a South American multicenter experience.Clin Transplant, 2013, 27(4):E469-E477.
10.	Morscio J, Dierickx D, Nijs J, et al.Clinicopathologic comparison of plasmablastic lymphoma in HIV-positive, immunocompetent, and posttransplant patients:single-center series of 25 cases and meta-analysis of 277 reported cases.Am J Surg Pathol, 2014, 38(7):875-886.
11.	Opelz G, Döhler B.Lymphomas after solid organ transplantation:a collaborative transplant study re-port.Am J Transplant, 2004, 4(2):222-230.
12.	Cohen JI.Epstein-Barr virus infection.N Engl J Med, 2000, 343(7):481-492.
13.	Kempf C, Tinguely M, Rushing EJ.Posttransplant lymphoprolifera-tive disorder of the central nervous system.Pathobiology, 2013, 80(6):310-318.
14.	Murray KA, Chor PJ, Turner JF Jr.Intrathoracic lymphoprolifera-tive disorders and lymphoma.Curr Probl Diagn Radiol, 1996, 25(3):78-106.
15.	Opelz G, Daniel V, Naujokat C, et al.Effect of cytomegalovirus prophylaxis with immunoglobulin or with antiviral drugs on post-transplant non-Hodgkin lymphoma:a multi-centre retrospective analysis.Lancet Oncol, 2007, 8(3):212-218.
16.	Haddad E, Paczesny S, Leblond V, et al.Treatment of B-lymphopro-liferative disorder with a monoclonal anti-interleukin-6 antibody in 12 patients:a mul-ticenter phase 1-2 clinical trial.Blood, 2001, 97(6):1590-1597.
17.	Morscio J, Dierickx D, Tousseyn T.Molecular pathogenesis of B-cell posttransplant lymphoproliferative disorder:what do we know so far? Clin Dev Immunol, 2013, 2013:150835.
18.	Wu L, Rappaport DC, Hanbidge A, et al.Lymphoproliferative disorders after liver transplantation:imaging features.Abdominal Imaging, 2001, 26(2):200-206.
19.	Nalesnik MA, Makowka L, Starzl TE.The diagnosis and treatment of posttransplant lymphoproliferative disorders.Curr Probl Surg, 1988, 25(6):367-472.
20.	Camacho JC, Moreno CC, Harri PA, et al.Posttransplantation lymphoproliferative disease:proposed imaging classification.Radiographics, 2014, 34(7):2025-2038.
21.	Nalesnik MA.The diverse pathology of post-transplant lymphopro-liferative disorders:the importance of a standardized approach.Transpl Infect Dis, 2001, 3(2):88-96.
22.	Nalesnik MA.Clinicopathologic characteristics of post-transplant lymphoproliferative disorders.Recent Results Cancer Res, 2002, 159:9-18.
23.	Nelson BP, Nalesnik MA, Bahler DW, et al.Epstein-Barr virus negative post-transplant lymphoproliferative disorders:a distinct entity? Am J Surg Pathol, 2000, 24(3):375-385.
24.	Pickhardt PJ, Siegel MJ, Anderson DC, et al.Chest radiography as a predictor of outcome in posttransplantation lymphoprolifera-tive disorder in lung allograft recipients.AJR Am J Roentgenol, 1998, 171(2):375-382.
25.	Donnelly LF, Frush DP, Marshall KW, et al.Lymphoproliferative disorders:CT findings in immunocompromised children.AJR Am J Roentgenol, 1998, 171(3):725-731.
26.	Strouse PJ, Platt JF, Francis IR, et al.Tumorous intrahepatic lymphoproliferative disorder in transplanted livers.AJR Am J Roentgenol, 1996, 167(5):1159-1162.
27.	Pickhardt PJ, Siegel MJ.Posttransplantation lym-phoproliferative disorder of the abdomen:CT evalu-ation in 51 patients.Radiology, 1999, 213(1):73-78.
28.	Armes JE, Angus P, Southey MC, et al.Lymphoproliferative disease of donor origin arising in patients after orthotopic liver transplan-tation.Cancer, 1994, 74(9):2436-2441.
29.	Lopez-Ben R, Smith JK, Kew II CE, et al.Focal posttransplantation lymphoproliferative disorder at renal allograft hilum.AJR Am J Roentgenol, 2000, 175(5):1417-1422.
30.	Vrachliotis TG, Vaswani KK, Davies EA, et al.CT findings in post-transplantation lymphoproliferative disorder of renal transplants.AJR Am J Roentgenol, 2000, 175(1):183-188.
31.	Pickhardt PJ, Siegel MJ.Abdominal manifestations of posttransplan-tation lymphoproliferative disorder.AJR Am J Roentgenol, 1998, 171(4):1007-1013.
32.	Dodd GD 3rd, Ledesma-Medina J, Baron RL, et al.Posttransplant lymphoproliferative disorder:intrathoracic manifestations.Radio-logy, 1992, 184(1):65-69.
33.	Diez Martinez P, Pakkal M, Prenovault J, et al.Postoperative ima ging after lung transplantation.Clin Imaging, 2013, 37(4):617-623.
34.	Carignan S, Staples CA, Muller NL.Intrathoracic lymphoprolifera-tive disorders in the immunocompromised patient:CT findings.Radiology, 1995, 197(1):53-58.
35.	Mucha K, Foroncewicz B, Palczewski P et al.Pulmonary post-transplant lymphoproliferative disorder with a CT halo sign.Ann Transpl, 2013, 18:482-487.
36.	Cavaliere R, Petroni G, Lopes MB, et al.Primary central nervous system post-transplantation lymphoprolif-erative disorder:an International Primary Central Nervous System Lymphoma Collaborative Group Report.Cancer, 2010, 116(4):863-870.
37.	Tubman DE, Frick MP, Hanto DW.Lymphoma after organ transplantation:radiologic manifestations in the central nervous system, thorax, and abdomen.Radiology, 1983, 149(3):625-631.
38.	Penn I.The price of immunotherapy.Curr Prob Surg, 1981, 18(11):681-751.
39.	Loevner LA, Karpati RL, Kumar P, et al.Posttransplantation lymphoproliferative disorder of the head and neck:imaging features in seven adults.Radiology, 2000, 216(2):363-369.

1. Penn I.Post-transplant malignancy:the role of im-munosuppression.Drug Saf, 2000, 23(2):101-113.
2. Engels EA, Pfeiffer RM, Fraumeni JF Jr, et al.Spec-trum of cancer risk among US solid organ transplant recipients.JAMA, 2011, 306(17):1891-1901.
3. Babcock GJ, Decker LL, Freeman RB, et al.Epstein-Barr virus-infected resting memory B cells, not proliferating lymphoblasts, accumulate in the peripheral blood of immunosup-pressed patients.J Exp Med, 1999, 190(4):567-576.
4. Choquet S, Varnous S, Deback C, et al.Adapted treatment of Eps-tein-Barr virus infection to prevent posttransplant lymphoprolifera-tive disorder after heart transplantation.Am J Transplant, 2014, 14(4), 857-886.
5. Scarsbrook AF, Warakaulle DR, Dattani M, et al.Post-transplan-tation lymphoproliferative disorder:the spectrum of imaging appearances.Clin Radiol, 2005, 60(1):47-55.
6. Végso G, Hajdu M, Sebestyén A.Lymphoprolifera-tive disorders after solid organ transplantati-on:clas-sification, incidence, risk factors, early detection and treatment options.Pathol Oncol Res, 2011, 17(3):443-454.
7. Quinlan SC, Pfeiffer RM, Morton LM, et al.Risk factors for early-onset and late-onset post-transplant lymphoproliferative disorder in kidney recipients in the United States.Am J Hematol, 2011, 86(2):206-209.
8. Penn I, Hammond W, Brettschneider L, et al.Malignant lymphoma in transplantation patients.Transplant Proc, 1969, 1:106-112.
9. Mendizabal M, Marciano S, Silva M, et al.Post-transplant lympho-proliferative disorder in adult liver transplant recipients:a South American multicenter experience.Clin Transplant, 2013, 27(4):E469-E477.
10. Morscio J, Dierickx D, Nijs J, et al.Clinicopathologic comparison of plasmablastic lymphoma in HIV-positive, immunocompetent, and posttransplant patients:single-center series of 25 cases and meta-analysis of 277 reported cases.Am J Surg Pathol, 2014, 38(7):875-886.
11. Opelz G, Döhler B.Lymphomas after solid organ transplantation:a collaborative transplant study re-port.Am J Transplant, 2004, 4(2):222-230.
12. Cohen JI.Epstein-Barr virus infection.N Engl J Med, 2000, 343(7):481-492.
13. Kempf C, Tinguely M, Rushing EJ.Posttransplant lymphoprolifera-tive disorder of the central nervous system.Pathobiology, 2013, 80(6):310-318.
14. Murray KA, Chor PJ, Turner JF Jr.Intrathoracic lymphoprolifera-tive disorders and lymphoma.Curr Probl Diagn Radiol, 1996, 25(3):78-106.
15. Opelz G, Daniel V, Naujokat C, et al.Effect of cytomegalovirus prophylaxis with immunoglobulin or with antiviral drugs on post-transplant non-Hodgkin lymphoma:a multi-centre retrospective analysis.Lancet Oncol, 2007, 8(3):212-218.
16. Haddad E, Paczesny S, Leblond V, et al.Treatment of B-lymphopro-liferative disorder with a monoclonal anti-interleukin-6 antibody in 12 patients:a mul-ticenter phase 1-2 clinical trial.Blood, 2001, 97(6):1590-1597.
17. Morscio J, Dierickx D, Tousseyn T.Molecular pathogenesis of B-cell posttransplant lymphoproliferative disorder:what do we know so far? Clin Dev Immunol, 2013, 2013:150835.
18. Wu L, Rappaport DC, Hanbidge A, et al.Lymphoproliferative disorders after liver transplantation:imaging features.Abdominal Imaging, 2001, 26(2):200-206.
19. Nalesnik MA, Makowka L, Starzl TE.The diagnosis and treatment of posttransplant lymphoproliferative disorders.Curr Probl Surg, 1988, 25(6):367-472.
20. Camacho JC, Moreno CC, Harri PA, et al.Posttransplantation lymphoproliferative disease:proposed imaging classification.Radiographics, 2014, 34(7):2025-2038.
21. Nalesnik MA.The diverse pathology of post-transplant lymphopro-liferative disorders:the importance of a standardized approach.Transpl Infect Dis, 2001, 3(2):88-96.
22. Nalesnik MA.Clinicopathologic characteristics of post-transplant lymphoproliferative disorders.Recent Results Cancer Res, 2002, 159:9-18.
23. Nelson BP, Nalesnik MA, Bahler DW, et al.Epstein-Barr virus negative post-transplant lymphoproliferative disorders:a distinct entity? Am J Surg Pathol, 2000, 24(3):375-385.
24. Pickhardt PJ, Siegel MJ, Anderson DC, et al.Chest radiography as a predictor of outcome in posttransplantation lymphoprolifera-tive disorder in lung allograft recipients.AJR Am J Roentgenol, 1998, 171(2):375-382.
25. Donnelly LF, Frush DP, Marshall KW, et al.Lymphoproliferative disorders:CT findings in immunocompromised children.AJR Am J Roentgenol, 1998, 171(3):725-731.
26. Strouse PJ, Platt JF, Francis IR, et al.Tumorous intrahepatic lymphoproliferative disorder in transplanted livers.AJR Am J Roentgenol, 1996, 167(5):1159-1162.
27. Pickhardt PJ, Siegel MJ.Posttransplantation lym-phoproliferative disorder of the abdomen:CT evalu-ation in 51 patients.Radiology, 1999, 213(1):73-78.
28. Armes JE, Angus P, Southey MC, et al.Lymphoproliferative disease of donor origin arising in patients after orthotopic liver transplan-tation.Cancer, 1994, 74(9):2436-2441.
29. Lopez-Ben R, Smith JK, Kew II CE, et al.Focal posttransplantation lymphoproliferative disorder at renal allograft hilum.AJR Am J Roentgenol, 2000, 175(5):1417-1422.
30. Vrachliotis TG, Vaswani KK, Davies EA, et al.CT findings in post-transplantation lymphoproliferative disorder of renal transplants.AJR Am J Roentgenol, 2000, 175(1):183-188.
31. Pickhardt PJ, Siegel MJ.Abdominal manifestations of posttransplan-tation lymphoproliferative disorder.AJR Am J Roentgenol, 1998, 171(4):1007-1013.
32. Dodd GD 3rd, Ledesma-Medina J, Baron RL, et al.Posttransplant lymphoproliferative disorder:intrathoracic manifestations.Radio-logy, 1992, 184(1):65-69.
33. Diez Martinez P, Pakkal M, Prenovault J, et al.Postoperative ima ging after lung transplantation.Clin Imaging, 2013, 37(4):617-623.
34. Carignan S, Staples CA, Muller NL.Intrathoracic lymphoprolifera-tive disorders in the immunocompromised patient:CT findings.Radiology, 1995, 197(1):53-58.
35. Mucha K, Foroncewicz B, Palczewski P et al.Pulmonary post-transplant lymphoproliferative disorder with a CT halo sign.Ann Transpl, 2013, 18:482-487.
36. Cavaliere R, Petroni G, Lopes MB, et al.Primary central nervous system post-transplantation lymphoprolif-erative disorder:an International Primary Central Nervous System Lymphoma Collaborative Group Report.Cancer, 2010, 116(4):863-870.
37. Tubman DE, Frick MP, Hanto DW.Lymphoma after organ transplantation:radiologic manifestations in the central nervous system, thorax, and abdomen.Radiology, 1983, 149(3):625-631.
38. Penn I.The price of immunotherapy.Curr Prob Surg, 1981, 18(11):681-751.
39. Loevner LA, Karpati RL, Kumar P, et al.Posttransplantation lymphoproliferative disorder of the head and neck:imaging features in seven adults.Radiology, 2000, 216(2):363-369.

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