Gao R, Zhang Y, Chen G, Bhekharee AK, Du Z, Chu S. Spontaneous regression of central nervous system posttransplant lymphoproliferative disease: A case report.
Medicine (Baltimore) 2021;
100:e24713. [PMID:
33578612 PMCID:
PMC10545224 DOI:
10.1097/md.0000000000024713]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 11/25/2022] Open
Abstract
RATIONALE
Primary central nervous system (CNS) posttransplant lymphoproliferative disease (PTLD) is a very rare entity. Patients may respond to reduction of immunosuppression or other therapies, but the prognosis is still pessimistic.
PATIENT CONCERNS
Herein, we report a 40-year-old female with a history of renal transplantation developed brain masses 4 years ago. Although brain biopsy was performed, PTLD was underdiagnosed then. No relevant treatment was administered. However, the lesions resolved spontaneously. After 4 years, new lesion appeared in a different brain region.
DIAGNOSES
The history of renal transplantation raised the suspicion of PTLD. Reexamination of previous brain sections confirmed the diagnosis of polymorphic PTLD (P-PTLD). A second biopsy of the new lesion also demonstrated P-PTLD.
INTERVENTIONS
She was referred to hematology department to receive rituximab.
OUTCOMES
After 4 rounds of treatment, the lesion resolved satisfactorily.
LESSONS
This case demonstrates the natural history of primary CNS P-PTLD. Although self-remission and recurrence is possible, aggressive measures should be taken to this condition.
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