Case report: A rare EBV-associated T/NK cell monomorphic posttransplant lymphoproliferative disorder

作者：Xin Jiang, Yaoyu Zhang, Xiaowei Li, Xiaodong Li, Zhanyuan Li, Wenjun Meng, Shadan Li · 发表于：Frontiers in Immunology · 年份：2024 · DOI：10.3389/fimmu.2024.1491681 · 被引用次数：4 · 研究领域：Viral-associated cancers and disorders、Cytomegalovirus and herpesvirus research、Lymphatic Disorders and Treatments

Background: Kidney transplantation (KT) is the best treatment for patients with end-stage renal disease. However, postoperative complications remain the main issues faced during KT recovery period. Posttransplant lymphoproliferative disorders (PTLD) are one of the severe and life-threatening complications that occur after KT while the recipient is undergoing immunosuppressive therapy. PTLD risk factors include Epstein-Barr virus (EBV) infection, the cumulative degree of immunosuppression, as well as genetic aspects. PTLD is more common in the transplanted organ itself and its surroundings, and the central nervous system, while PTLD involving the pharyngeal soft tissue is relatively rare, with only a few reported case reports. Therefore, systematic experience is scarce regarding whether the treatment or the care. Case presentation: Herein, we report a 41-year-old male, underwent a reproductive KT due to chronic renal insufficiency. Recurrent fever, pharyngeal pain, and bilateral cervical lymph node enlargement were recurred during five years' follow-up after KT surgery. In this inpatient experience, the patient vomited a large amount of blood from the oropharynx, then the tonsil artery was ligated by emergency operation. EBV-associated T/NK cell monomorphic PTLD was eventually diagnosed by blood EBV DNA test, pharyngeal biopsy, and corresponding pathological examination. After six cycles of R-CHOP chemotherapy, the clinical symptoms and laboratory tests changed into normal. Su...