Anaplastic large cell lymphoma (monomorphic post-transplant lymphoproliferative disorder) presenting in gallbladder

Abstract

Primary lymphomas of the gallbladder are rare, particularly in the post-transplant setting. Post-transplant lymphoproliferative disorder (PTLD) is a well-described complication of the immunosuppressive therapy employed post-transplant and manifests as a broad spectrum of disease ranging from polymorphic lymphoid proliferations to monomorphic lymphomas. The majority of PTLD consists of B-cell proliferations, although a small subset involves T-cell neoplasms. Of T-cell PTLD, anaplastic large cell lymphoma (ALCL) is a rare subtype. Of note, there are no reported cases of ALCL localized to the gallbladder in either the posttransplant setting or otherwise. We report a case of ALCL (monomorphic PTLD) in a 45-year-old male lung transplant recipient. Within the first year post-transplant, the patient presented with sepsis and acalculous cholecystitis. The patient ultimately underwent an open cholecystectomy and was subsequently found to have ALCL of the gallbladder. Despite aggressive treatment of septic shock, renal failure, and coagulopathy, the patient died 5 days after presentation.

Anaplastic large cell lymphoma as a posttransplant lymphoproliferative disorder in a renal transplant patient: A case report

“…The patient died due to acute cholecystitis prior to receiving any lymphoma specific treatment. 8 In our literature search, there was only one published case of a successfully treated ALCL in the setting of PTLD of a 13 year old boy treated with reducing his immune suppression and chemotherapy: ACVBP that includes Doxorobucin, Cyclophosphamide, Vincristine, bleomycin, and Prednisone for 6 cycles with preservation of his graft function. 9 Of interest, Willenbacher et al published a case of a late ALCL in the setting of lung transplant.…”