Sažetak sa skupa

Post-transplant lymphoproliferative disorder of the thyroid gland

Stjepan Brnić orcid.org/0000-0002-8218-7854 ; KB Merkur, Zajčeva 19, 10000 Zagreb, Hrvatska
Luka Vučemilo orcid.org/0000-0002-9089-7477 ; KB Merkur, Zajčeva 19, 10000 Zagreb, Hrvatska

Sažetak

Post-transplant lymphoproliferative disorder (PTLD) encompasses a wide spectrum of diseases that arise as a
consequence of chronic immunosuppression after solid organ or hematopoietic stem cell transplantation. It is
characterized by uncontrolled proliferation of B or T lymphocytes, in many cases triggered by Epstein-Barr
virus (EBV) infection. It most commonly involves lymphatic tissue, but extranodal disease is not uncommon,
most often affecting the liver, lungs, or skin. Thyroid involvement represents an exceptionally rare
manifestation of PTLD, usually mimicking aggressive primary thyroid carcinoma in clinical presentation and
imaging findings. We present the case of an 82-year-old male patient who underwent liver transplantation in
2004. He was admitted with dyspnea and a progressively enlarging right-sided neck mass. Clinical examination
revealed an enlarged thyroid and cervical lymph nodes, while fiberoptic laryngoscopy showed a bulge of the
posterior tracheal wall without airway compromise. Radiological work-up demonstrated diffuse thyroid
enlargement with infiltration of surrounding structures (cricoid cartilage, trachea), encasement of the
brachiocephalic trunk, necrotic lymph nodes bilaterally in the neck and mediastinum, and multiple secondary
lesions in the lung parenchyma. Based on the working diagnosis of thyroid neoplasm, primarily anaplastic
carcinoma, further evaluation was conducted. Given the profound chronic immunosuppression, a
lymphoproliferative disorder was also considered. Hematologic testing revealed elevated EBV DNA copies in
the blood. Fine needle aspiration of the thyroid and cervical lymph nodes suggested diffuse large B-cell
lymphoma, and histopathological analysis of an excised cervical lymph node confirmed PTLD. This case
highlights the importance of considering PTLD in the differential diagnosis of neck and thyroid tumors in
transplant recipients. We also emphasize the importance of regular long-term surveillance of
immunosuppressed patients to enable a timely detection of de novo malignant diseases

Ključne riječi

anaplastic carcinoma; lymphoma; thyroid gland; transplant

Hrčak ID:

336283

URI

https://hrcak.srce.hr/336283

Datum izdavanja:

10.11.2025.

Posjeta: 143 *