Journal List > J Korean Soc Transplant > v.30(1) > 1034503

Park, Kim, Kong, Kim, Park, Song, Yang, Han, and Choi: Post-transplant Lymphoproliferative Disorder in Transplanted Kidney Causing Urinary Tract Obstruction

Abstract

Post-transplant lymphoproliferative disorder (PTLD) is a serious complication resulting in mortality and renal graft failure. PTLD is a heterogeneous disorder, which causes different clinical forms of disease from non-specific viral syndrome to malignant lymphoma and has various etiologies, clinical features, and treatment strategies. Here, we report on a patient who had a PTLD in the hilum of a transplanted kidney at 5 months after renal transplantation. The PTLD resulted in hydronephrosis of the transplanted kidney and graft dysfunction by local urinary tract obstruction. Despite treatment including immunosuppression reduction and rituximab administration, we removed the transplanted kidney from the recipient because the PTLD did not respond to the therapy.

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Fig. 1.
Transplanted kidney mass seen on ultrasound sonography (A) and computed tomography (B). The mass in the hilum of transplanted kidney causes hydronephrosis by local urinary tract obstruction.
jkstn-30-44f1.tif
Fig. 2.
Microscopic findings of renal mass tissue obtained by fine-needle aspiration biopsy. The tissue shows proliferation of lymphoid cells including B, T, and plasma cells (A, HE stain, ×200; B, CD20, ×200; C, CD3, ×200). Epstein Barr virus in situ hybridization shows positive staining (D, ×100).
jkstn-30-44f2.tif
Fig. 3.
Gross appearance of transplanted kidney removed from recipient. The tumor size is 5×4.5×4 cm in the hilum of transplanted kidney.
jkstn-30-44f3.tif
Fig. 4.
Immunohistochemistry for immunoglobulin light chain of renal mass tissue. The staining both for kappa and lambda light chains shows positive, but is restricted for lambda light chain (A: kappa chain, ×100; B: lambda chain, ×100).
jkstn-30-44f4.tif
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