A rare cause of ulcerative colitis - diarrhoea and perianal bleeding due to posttransplant lymphoproliferative disorder (PTLD).
Z Gastroenterol
; 47(3): 283-7, 2009 Mar.
Article
em En
| MEDLINE
| ID: mdl-19280542
ABSTRACT
Post-transplant lymphoproliferative disorder (PTLD) is characterised by frequent extranodal manifestation, in 20 - 25 % including the gastrointestinal tract. This entity, which is more frequent after solid organ transplantation, rarely occurs after bone marrow transplantation (BMT). We report the case of a 43-year-old male presenting with a short history of rectal bleeding, diarrhoea and weight loss. He had received a bone marrow transplant two years previously for an acute lymphocytic leukaemia of B-cell origin. On sigmoidoscopy, deep ulcerations of the rectal and sigmoideal mucosa were found. Further investigations revealed a diffuse infiltration of the liver, spleen, both kidneys and lungs. Histologically, a monomorphic post-transplant lymphoproliferative disorder was diagnosed, the subtype was a high grade diffuse-large cell Non-Hodgkin's lymphoma of B-cell origin. The biopsies showed that a major proportion of cells expressed Epstein-Barr virus encoded proteins typical for latent as well as lytic EBV infection. This is a common feature of PTLD and possibly plays a critical role in its pathogenesis. The current therapeutic approach to the subtype of PTLD we saw in this patient is CHOP chemotherapy, comprising the anti-CD 20 antibody rituximab if CD 20-positivity is present. This patient had a fatal course of the disease and died a few days after the first chemotherapy cycle due to severe multiple organ failure.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Tipos_de_cancer
/
Colon_e_reto
/
Tratamento
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Leucemia-Linfoma Linfoblástico de Células Precursoras B
/
Colite Ulcerativa
/
Linfoma Difuso de Grandes Células B
/
Transplante de Células-Tronco Hematopoéticas
/
Diarreia
/
Hemorragia Gastrointestinal
/
Antineoplásicos
Limite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
Z Gastroenterol
Ano de publicação:
2009
Tipo de documento:
Article