Post-transplant lymphoproliferative disease of the larynx

Nathan D Vandjelovic; Patrick C Barth; Stephen P Dunn; Kudakwashe R Chikwava; Udayan K Shah

doi:10.1093/jscr/rjz111

Post-transplant lymphoproliferative disease of the larynx

J Surg Case Rep. 2019 Apr 6;2019(4):rjz111. doi: 10.1093/jscr/rjz111. eCollection 2019 Apr.

Authors

Nathan D Vandjelovic^{1

2}, Patrick C Barth^{1

2

3}, Stephen P Dunn^{3

4}, Kudakwashe R Chikwava⁵, Udayan K Shah^{1

2

3}

Affiliations

¹ Division of Pediatric Otolaryngology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
² Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
³ Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA.
⁴ Division of Pediatric General Surgery/Solid Organ Transplantation, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
⁵ Department of Pathology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA.

Abstract

Laryngeal post-transplant lymphoproliferative disease (PTLD) is rare. Here, we describe two pediatric cases. The first, a 15-month-old who underwent liver transplantation at 5 weeks, presented with airway distress. Airway evaluation identified epiglottic and arytenoid infiltrate, and biopsy was consistent with polymorphic PTLD. The second, a 23-month-old who underwent liver transplantation at 13 months, presented with progressive stridor. Airway evaluation revealed sub-mucosal infiltrate of the epiglottis, arytenoids, post-cricoid region, and uvula. Biopsy was consistent with monomorphic PTLD. Airway findings and symptoms resolved for both after immunosuppression reduction. PTLD diagnosis requires a high index of suspicion in post-transplant patients with airway obstruction.

Publication types

Case Reports