| Title: | Post-transplant indolent T cell lymphoproliferative disorder in living donor liver transplantation : a case report |
| Authors: | Goto, Ryoichi Browse this author →KAKEN DB |
| Kawamura, Norio Browse this author →KAKEN DB |
| Watanabe, Masaaki Browse this author →KAKEN DB |
| Koshizuka, Yasuyuki Browse this author |
| Shiratori, Souichi Browse this author →KAKEN DB |
| Ara, Momoko Browse this author →KAKEN DB |
| Honda, Shohei Browse this author →KAKEN DB |
| Mitsuhashi, Tomoko Browse this author →KAKEN DB |
| Matsuno, Yoshihiro Browse this author →KAKEN DB |
| Shimamura, Tsuyoshi Browse this author →KAKEN DB |
| Taketomi, Akinobu Browse this author →KAKEN DB |
| Keywords: | Indolent T cell lymphoproliferative disorder |
| Post-transplant lymphoproliferative disorder |
| Living donor liver transplantation |
| Issue Date: | 26-Jun-2020 |
| Publisher: | Springer |
| Journal Title: | Surgical case reports |
| Volume: | 6 |
| Issue: | 1 |
| Start Page: | 147 |
| Publisher DOI: | 10.1186/s40792-020-00904-y |
| Abstract: | Background Post-transplant lymphoproliferative disorder (PTLD) of T cell type has been rarely reported. Accurate diagnosis of this life-threatening rare form of PTLD is important for the treatment strategy. Case presentation A 7-year-old boy had severe diarrhea and weight loss progressively at 7 years post-living donor liver transplantation (LDLT) for biliary atresia. Endoscopy in the gastrointestinal (GI) tract revealed multiple erosions and ulcer lesions with prominent intraepithelial lymphocytosis in the duodenum and terminal ileum. Immunohistochemical examination demonstrated that these accumulated lymphocytes mainly comprised small- to medium-sized T cells expressing CD3, CD4, CD5, CD7, and CD103, but lacking CD8, CD56, and Epstein-Barr virus-encoded small RNAs. In addition, T cell receptor beta gene rearrangement was detected by polymerase chain reaction analysis. Comprehensively, the lesions were best interpreted as post-transplant indolent T cell lymphoproliferative disorder (LPD) of the intestine. Clinical remission was achieved by reducing the immunosuppressant. Conclusion A rarely reported indolent type of T cell LPD in post-LDLT was diagnosed by direct inspection and histological investigation. Although the histological classification and therapeutic strategy for post-transplant indolent T cell LPD have not been established, reducing immunosuppression allowed complete remission in our case. To prevent the incidence of PTLD and de novo malignancy, developing a methodology to set a proper dose of immunosuppressant is required. |
| Rights: | https://creativecommons.org/licenses/by/4.0/ |
| Type: | article |
| URI: | http://hdl.handle.net/2115/79075 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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