Open in a separate window Post-transplant lymphomas are more likely than general lymphomas to have extranodal involvement, high grade, aggressive clinical behavior, and poor outcomes. Symptoms may include fever, lymphadenopathy, weight loss, or splenomegaly.
Abstract Lymphoma is the seventh most common type of malignancy in both sexes. It is a neoplastic proliferation of lymphoid cells at various stages of differentiation and affects lymph nodes with infiltration into the bone marrow, spleen and thymus. However, extra nodal involvement is frequently seen in many cases.
Extranodal lymphoma can present with diverse manifestations and sometimes mimics other organ-related pathologies. Knowledge of the protean manifestations of extranodal lymphoma is required to accurately detect the disease and differentiate it from the various physiologic and benign causes of FDG uptake in various organs.
Lymphoma is the seventh most common malignancy in both sexes together[ 1 ]. Extranodal lymphoma, by definition, involves sites other than lymph nodes, spleen, thymus and the pharyngeal lymphatic ring.
Involvement of the spleen in HD is considered as nodal disease but in the case of non-Hodgkin lymphoma NHL the spleen is regarded as an extranodal site[ 4 ]. Distinct radiologic features are seen when such extranodal involvement is noted. Differentiation between disseminated lymph nodal disease involving an extranodal site and primary extranodal disease is challenging.
Therefore disease with involvement of an extranodal organ along with draining lymph nodes only or disease in which the predominant site is extranodal are grouped in this category.
Central nervous system Central nervous system CNS lymphomas constitute approximately 6. The incidence of CNS lymphoma is higher in immunocompromised individuals. CNS lymphomas are usually of B cell type. On CT scan, the lesions are hyperdense and enhance. However, the presence of physiologic uptake in the cerebral cortex may hinder the evaluation of CNS lymphomas.
Lymphomas demonstrate intense FDG uptake Fig.Malignancies: In transplant recipients, there exists a % incidence of posttransplant lymphoproliferative disease (PTLD) and an % incidence of nonmelanoma skin carcinoma (reported over a three-year period of follow-up) (Mathew Mathew, T.
H. The large majority of the post-transplant lymphoproliferative disorders (PTLD) have a B-cell origin, although some T-cell PTLD have been described. 64, 65 These malignancies are thus excluded from this chapter on late effects and have been extensively reviewed elsewhere.
Aibin Zhang, Min Zhang, Yan Shen, Weilin Wang and Shusen Zheng, Hepatitis B virus reactivation is a risk factor for development of post‐transplant lymphoproliferative disease after liver transplantation, Clinical Transplantation, 23, 5, (), ().
SPECIFIC AGENTS USED IN SOLID ORGAN TRANSPLANT. Muromonab.
Muromonab was the first monoclonal antibody used in solid organ transplantation. Muromonab is a murine monoclonal antibody directed against human CD3 receptor, which is situated on the T-cell antigen receptor of mature T-cells, inducing apoptosis of the target cell (Bodziak, ; Wilde, ).
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· Presence of any neoplasms, particularly post-transplant lymphoproliferative disease · Presence of any complications related to ther-apy (drug toxicity) · When appropriate sampling has not occurred, it is essential to note in the pathology report that the biopsy findings may not be fully repre-sentative of the changes in the graft.