Korean J Nephrol.  2007 Sep;26(5):651-656.

A Case of Post-Transplant Lymphoproliferative Disorder Presenting with Hydronephrosis after Kidney Transplantation

• Lee YG
• Park JS
• Lee CH
• Kim GH
• Kang CM
• Park CG

Abstract

Lymphoproliferative disorders are among the most serious and potentially fatal complications of chronic immunosuppression in organ transplant recipients. Post-transplant lymphoproliferative disorder (PTLD) is the second common malignancy occurring in patients with kidney transplantation and has a high mortality rate. The pathogenesis of PTLD in most cases appears to be related to B cell proliferation induced by infection with Epstein-Barr virus (EBV) in the setting of chronic immunosuppression. The PTLD may present a solitary tumor around the hilum of transplant kidney, but it may not by easily considered as the cause of hydronephrosis in transplant kidney because the prevalence of PTLD is low and surgical complications such as lymphocele, stricture and hematoma that obstruct the transplant ureter are much more common. Early detection is important because reduction of immunosuppressive agents may reverse progression of the disease. Furthermore, several effective treatment options were recently introduced. Here we report a case of PTLD presenting with hydronephrosis, which was completely resolved by a multimodality therapeutic approach.

Keyword

Lymphoproliferative disorders; Hydronephrosis; Kidney transplantation

MeSH Terms

Cell Proliferation
Constriction, Pathologic
Hematoma
Herpesvirus 4, Human
Humans
Hydronephrosis*
Immunosuppression
Immunosuppressive Agents
Kidney Transplantation*
Kidney*
Lymphocele
Lymphoproliferative Disorders*
Mortality
Prevalence
Transplants
Ureter
Immunosuppressive Agents