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Unusual lymphoproliferative oropharyngeal lesions in heart and heart-lung transplant recipients

Published online by Cambridge University Press:  29 June 2007

James W. Fairley*
Affiliation:
Department of ENT Surgery, Mount Vcrnon Hospital, Northwood, Middlesex HA6 2RN
Beverley J. Hunt
Affiliation:
Department of Senior Registrar in Research Haematology, Harefield Hospital, Harefield, Middlesex UB9 6JH
Garry W. Glover
Affiliation:
Department of ENT Surgery, Mount Vcrnon Hospital, Northwood, Middlesex HA6 2RN
Rosemary C. Radley-Smith
Affiliation:
Department of Consultant Paediatric Cardiologist, Harefield Hospital, Harefield, Middlesex UB9 6JH
Magdi H. Yacoub
Affiliation:
Department of Cardiothoracic Surgery, Harefield Hospital, Harefield, Middlesex UB9 6JH
*
Mr. J. W. Fairley, Senior ENT Registrar, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF.

Abstract

Three unusual cases of oropharyngeal lympho-proliferative lesions were seen in recipients of heart and heart-lung transplants. Two caused acute upper respiratory obstruction necessitating urgent ENT intervention. All patients were receiving immunosuppressive drugs including cyclosporin. The two obstructive cases were adenotonsillar enlargement in a 6-year-old, and a tumour of the tonsil and tongue base with cervical lymph node enlargement in a 32-year-old male. Both were caused by Epstein-Barr Virus-associated lymphoproliferative disorder. The third patient, a 32-year-old female, had a presumed low grade T-cell lymphoma that regressed spontaneously.

Histopathological diagnosis of these lympho-proliferative disorders after transplantation usually requires immunocytochemistry to distinguish polyclonal proliferative disorders from true lymphoma. Polyclonal lymphoproliferative disorders after transplantation do not usually require aggressive cytoreductive therapy, but respond to simple measures such as the reduction of immunosuppression.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1990

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