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Isolated Upper Extremity Posttransplant Lymphoproliferative Disorder in a Child.

Halula SE, Leino DG, Patel MN, Racadio JM, Lungren MP - Case Rep Radiol (2015)

Bottom Line: The most common presentation is intra-abdominal lymphadenopathy or single or multiple intraparenchymal masses involving the liver, spleen, or kidneys.Here we describe the imaging and pathology findings of an unusual case of PTLD appearing as an intramuscular forearm lesion in a pediatric male.The manifestation of PTLD as an isolated upper extremity mass in a pediatric patient has to our knowledge not been described.

View Article: PubMed Central - PubMed

Affiliation: Division of Pediatric Interventional Radiology, Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3030, USA.

ABSTRACT
Posttransplant lymphoproliferative disorder (PTLD) is a well-described complication of solid organ and bone marrow transplants. The most common presentation is intra-abdominal lymphadenopathy or single or multiple intraparenchymal masses involving the liver, spleen, or kidneys. Here we describe the imaging and pathology findings of an unusual case of PTLD appearing as an intramuscular forearm lesion in a pediatric male. The manifestation of PTLD as an isolated upper extremity mass in a pediatric patient has to our knowledge not been described.

No MeSH data available.


Related in: MedlinePlus

Histomorphologic and immunohistochemical analysis. (a) Relatively monotonous population of atypical lymphocytes infiltrating in adipose tissue with round to angulated nuclei, condensed nuclear chromatin, and inconspicuous nucleoli. The right side shows the same population of cells from the left in various stages of necrosis (H&E stained, formalin fixed, paraffin embedded section, at 40x magnification). (b) Immunohistochemical stain for CD79a, a B-cell specific antigen (formalin fixed, paraffin embedded section, at 40x magnification).
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fig4: Histomorphologic and immunohistochemical analysis. (a) Relatively monotonous population of atypical lymphocytes infiltrating in adipose tissue with round to angulated nuclei, condensed nuclear chromatin, and inconspicuous nucleoli. The right side shows the same population of cells from the left in various stages of necrosis (H&E stained, formalin fixed, paraffin embedded section, at 40x magnification). (b) Immunohistochemical stain for CD79a, a B-cell specific antigen (formalin fixed, paraffin embedded section, at 40x magnification).

Mentions: Due to the atypical presentation and the lack of a trauma history or supporting clinical evidence for infection, ultrasound guided biopsy of the mass was performed. Histomorphologic analysis revealed an atypical, diffuse lymphoid infiltrate composed of a relatively monotonous population of cells. By immunohistochemical staining, these cells were diffusely positive for CD79a (Figure 4), a subset immunoreactive to CD20, and all were negative for CD3, all indicative of a B-cell lineage. CD30 was present on many cells of variable size including some larger forms with a membranous and perinuclear dot-like pattern. The MIB-1 (Ki-67) showed a proliferation index of approximately 70%. In situ hybridization with EBER (EBV) showed strong positivity (nuclear) in several clusters of the atypical B-cells. PCR viral studies performed on the tissue confirmed a diagnosis compatible with posttransplant lymphoproliferative disorder (PTLD), monomorphic type [5].


Isolated Upper Extremity Posttransplant Lymphoproliferative Disorder in a Child.

Halula SE, Leino DG, Patel MN, Racadio JM, Lungren MP - Case Rep Radiol (2015)

Histomorphologic and immunohistochemical analysis. (a) Relatively monotonous population of atypical lymphocytes infiltrating in adipose tissue with round to angulated nuclei, condensed nuclear chromatin, and inconspicuous nucleoli. The right side shows the same population of cells from the left in various stages of necrosis (H&E stained, formalin fixed, paraffin embedded section, at 40x magnification). (b) Immunohistochemical stain for CD79a, a B-cell specific antigen (formalin fixed, paraffin embedded section, at 40x magnification).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4488545&req=5

fig4: Histomorphologic and immunohistochemical analysis. (a) Relatively monotonous population of atypical lymphocytes infiltrating in adipose tissue with round to angulated nuclei, condensed nuclear chromatin, and inconspicuous nucleoli. The right side shows the same population of cells from the left in various stages of necrosis (H&E stained, formalin fixed, paraffin embedded section, at 40x magnification). (b) Immunohistochemical stain for CD79a, a B-cell specific antigen (formalin fixed, paraffin embedded section, at 40x magnification).
Mentions: Due to the atypical presentation and the lack of a trauma history or supporting clinical evidence for infection, ultrasound guided biopsy of the mass was performed. Histomorphologic analysis revealed an atypical, diffuse lymphoid infiltrate composed of a relatively monotonous population of cells. By immunohistochemical staining, these cells were diffusely positive for CD79a (Figure 4), a subset immunoreactive to CD20, and all were negative for CD3, all indicative of a B-cell lineage. CD30 was present on many cells of variable size including some larger forms with a membranous and perinuclear dot-like pattern. The MIB-1 (Ki-67) showed a proliferation index of approximately 70%. In situ hybridization with EBER (EBV) showed strong positivity (nuclear) in several clusters of the atypical B-cells. PCR viral studies performed on the tissue confirmed a diagnosis compatible with posttransplant lymphoproliferative disorder (PTLD), monomorphic type [5].

Bottom Line: The most common presentation is intra-abdominal lymphadenopathy or single or multiple intraparenchymal masses involving the liver, spleen, or kidneys.Here we describe the imaging and pathology findings of an unusual case of PTLD appearing as an intramuscular forearm lesion in a pediatric male.The manifestation of PTLD as an isolated upper extremity mass in a pediatric patient has to our knowledge not been described.

View Article: PubMed Central - PubMed

Affiliation: Division of Pediatric Interventional Radiology, Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3030, USA.

ABSTRACT
Posttransplant lymphoproliferative disorder (PTLD) is a well-described complication of solid organ and bone marrow transplants. The most common presentation is intra-abdominal lymphadenopathy or single or multiple intraparenchymal masses involving the liver, spleen, or kidneys. Here we describe the imaging and pathology findings of an unusual case of PTLD appearing as an intramuscular forearm lesion in a pediatric male. The manifestation of PTLD as an isolated upper extremity mass in a pediatric patient has to our knowledge not been described.

No MeSH data available.


Related in: MedlinePlus