Early gastric post-transplantation lymphoproliferative disorder and H pylori detection after kidney transplantation: A case report and review of the literature

The incidence of post-transplantation lymphoproliferative disorder (PTLD) i n the adult renal transplant population ranges from 0.7% to 4% The majority of cases involve a single site and arise, on average, seven months after t ransplantation. Histopathology usually reveals B-cell proliferative disease and has been standardized into its own classification. Treatment modalitie s consist: of decreased immunosuppression, eradication of Epstein-Barr viru s, surgical resection, systemic chemotherapy and monoclonal antibody therap y; however, mortality remains high, typically with a short survival time. I n patients who have undergone renal transplantation, approximately 10% of t hose with PTLDs present with gastrointestinal symptomatology and disease. R eported sites include the stomach, and small and large bowel. Very few case s of Helicobacter pylori or mucosal-associated lymphoid tissue have been de scribed in association with PTLD. In the era of cyclosporine immunosuppress ion, the incidence of PTLD affecting the gastrointestinal tract may be incr easing in comparison with the incidence seen with the use of older immunosu ppression regimens. A case of antral PTLD and H pylori infection occurring three months after renal transplantation is presented, and the natural hist ory and management of gastric PTLD are reviewed.