Background: To define the imaging features of lymphoproliferative disorders
that occur after liver transplantation.
Methods: A retrospective review of 605 liver transplantations between 1985
and 1998 showed 20 patients with posttransplantation lymphoproliferative di
sorders (PTLDs). All relevant clinical, imaging, and pathologic findings we
re reviewed.
Results: PTLDs occurred in 13 men and seven women (mean age = 43.3 years, a
ge range = 18-68 years). The time to diagnosis of disease ranged from 1.5 t
o 51 months (mean = 14 months) posttransplantation. Cervical, thoracic, or
abdominal lymphadenopathy was seen in II patients (55%). A complex portal m
ass in five patients (25%) was the second most common manifestation of PTLD
, ranging in size from 5 to 12 cm. Other findings included gastrointestinal
tract involvement in three patients (15%) seen as a duodenal mass and diff
use wall thickening in one patient and large bowel thickening in two patien
ts with preexisting inflammatory bowel disease.
Conclusion: There is a wide spectrum of findings in lymphoproliferative dis
order after liver transplantation. The presence of lymphadenopathy, a porta
l mass, or bowel thickening indicates a need for further investigation to r
each a pathologic diagnosis.