Cutaneous plasmacytoma-like posttransplant lymphoproliferative disorder after renal transplantation with response to imiquimod 5% cream and reduced immunosuppression

Traboulsi, Danya; Wink, John; Wong, Rachel; Auer, Iwona; Gill, Pavandeep; Tay, Jason; Hardin, Jori

doi:10.1016/j.jdcr.2019.10.005

Cited by 3 publications

(10 citation statements)

References 22 publications

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“…4 Presentation of the plasma cell neoplasm variant of monomorphic PTLD limited to the skin is rare, with fewer than 20 cases reported in the literature. 6,8,9,[11][12][13][14][15][16][17][18][19][20] Most reported cases of cutaneous monomorphic PTLD, plasma cell neoplasm variant, present as single skin nodules 6,9 on the extremities 9 with few reports of erythematous plaques or ulcerations. 6,12,16 Squamous cell carcinoma is an important diagnostic consideration in patients who have undergone solid organ transplantation as they are among the most common malignancies in this population.…”

Section: Discussionmentioning

confidence: 99%

“…Given the role that immunosuppression plays in the development of PTLD, it is not surprising that PTLD is more likely to occur in transplant recipients that require higher levels of immunosuppression such as heart, lung, and multiorgan transplants. 4,5 Renal transplant recipients are at the lowest risk 6 with only 0.3%–3% of renal transplant patients developing PTLD. 7 Most cases of PTLD occur within the first year of transplant, 8 but there has been shown to be a bimodal incidence of cases.…”

Section: Discussionmentioning

confidence: 99%

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Primary Cutaneous Monomorphic Post-transplant Lymphoproliferative Disorder Mimicking Squamous Cell Carcinoma In Situ

Craddock¹,

Gru²,

Mannschreck

et al. 2021

The American Journal of Dermatopathology

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Post-transplant lymphoproliferative disorder (PTLD) is a term used to describe a range of lymphoproliferative disorders that occur after solid organ transplant. Although the clinical presentation is variable, primary cutaneous PTLD typically presents as isolated nodules that appear as dermal-based proliferations. We present a case of a 70-year-old woman with a history of a kidney transplant who presented with a 2-month history of an asymptomatic, erythematous plaque on the right shin, clinically suspected to be squamous cell carcinoma in situ. Histomorphology demonstrated a dermal proliferation of atypical plasma cells with dense chromatin, variable nucleoli, and irregular nuclear borders. The atypical plasma cells were positive for Epstein-Barr virus by in situ hybridization and markedly kappa-restricted by RNAscope in situ hybridization. A diagnosis of cutaneous monomorphic PTLD, plasma cell neoplasm variant, was rendered, a rare diagnosis in the skin. Treatment for PTLD typically involves reduction of immunosuppression, although our patient progressed and developed new lesions despite this intervention. In this study, we present an atypical presentation of cutaneous PTLD, plasma cell neoplasm variant, presenting as squamous cell carcinoma in situ.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Primary Cutaneous Monomorphic Post-transplant Lymphoproliferative Disorder Mimicking Squamous Cell Carcinoma In Situ

Craddock¹,

Gru²,

Mannschreck

et al. 2021

The American Journal of Dermatopathology

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“…About 5% of cases of PTLD involve the skin 7 . Table 1 summarizes reported cases of cutaneous PTLD, including our four cases 15‐25 . Most reported cases with only skin involvement evolved with disease remission, as described by Murad et al, 15 Snavely et al, 8 Traboulsi et al, 17 Capaldi et al 24 and Dabbs et al 21 Treatment in these cases was quite variable, with the majority including reduction of immunosuppression.…”

Section: Discussionmentioning

confidence: 72%

“…Table 1 summarizes reported cases of cutaneous PTLD, including our four cases 15‐25 . Most reported cases with only skin involvement evolved with disease remission, as described by Murad et al, 15 Snavely et al, 8 Traboulsi et al, 17 Capaldi et al 24 and Dabbs et al 21 Treatment in these cases was quite variable, with the majority including reduction of immunosuppression. On the other hand, reported cases with other organ involvement showed worse outcomes, with majority of fatal outcomes, as described by Schumann et al, 25 Blokx et al, 19 Coyne et al 20 and Salama et al 7 All of these cases corresponded to monomorphic PTLD.…”

Section: Discussionmentioning

confidence: 78%

Post‐transplant lymphoproliferative disorder with cutaneous involvement: A series of four cases

Ferreira

Seque

Enokihara

et al. 2020

Clinical Transplantation

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Background Post‐transplant lymphoproliferative disorders (PTLD) are lymphoid proliferations associated with post‐transplant immunosuppression. Most originate from B cells and are associated with Epstein‐Barr virus (EBV) infection. Although extranodal involvement is common, cutaneous presentation is rare. Objective To report and characterize cutaneous manifestations of PTLD from clinical, histopathologic, and immunohistochemistry standpoints. Methods Patients' information was obtained retrospectively by reviewing medical records. Skin biopsies were submitted to histological and immunohistochemistry analysis, and EBV detection was performed by in situ hybridization and polymerase chain reaction (PCR) analysis. Staging examinations were included. A literature review of reported cutaneous PTLD cases was performed. Results We describe two cases of primary cutaneous and 2 cases of systemic PTLD with secondary cutaneous manifestations. All had late onset disease, which presented at least 6 years after transplantation. Histopathologic findings were compatible with monomorphic PTLD in three cases and plasmacytic hyperplasia in one case. EBV was detected in two patients. Both patients with systemic disease had fatal outcome, and those with primary cutaneous involvement responded to treatment. Limitations Due to the rare incidence of cutaneous manifestation of PTLD, the analysis of a large number of cases was not possible. Conclusion Although rare, PTLD should be considered in the differential diagnosis of late onset cutaneous complications post‐renal transplant.

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“…Cutaneous involvement occurs in only 5% of PTLD cases, with most cases being monomorphic (more frequently B-cell than T-cell). 14,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Although the onset with cutaneous involvement is considered a favorable factor, the prognosis of these cases is reserved, with a significant percentage of them ending in death.…”

Section: Discussionmentioning

confidence: 99%

Post-Transplant Lymphoproliferative Disorder, Monomorphic Type, in a Kidney Transplant Patient After Administration of Anti-Influenza Vaccine

Fernandez-Flores,

Nieto Rodriguez,

Fernandez-Parrado

et al. 2023

The American Journal of Dermatopathology

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Post-transplant lymphoproliferative disorders (PTLD) are rare complications in solid organ transplant patients. Their pathogenesis is largely unknown and closely linked to low immunity, which allows uncontrolled lymphocyte proliferation. Although transplant patients receive annual influenza vaccination as a preventive protocol, we have not found any cases where the flu vaccine triggered a PTLD. We present the case of a 49-year-old female kidney transplant recipient who developed an Epstein–Barr virus-negative PTLD, CD30+ anaplastic monomorphic type, ALK-, which presented the day after a single dose of anti-influenza vaccine. The initial clinical presentation was subcutaneous, but imaging studies revealed multiorgan involvement.

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Cutaneous plasmacytoma-like posttransplant lymphoproliferative disorder after renal transplantation with response to imiquimod 5% cream and reduced immunosuppression

Cited by 3 publications

References 22 publications

Primary Cutaneous Monomorphic Post-transplant Lymphoproliferative Disorder Mimicking Squamous Cell Carcinoma In Situ

Primary Cutaneous Monomorphic Post-transplant Lymphoproliferative Disorder Mimicking Squamous Cell Carcinoma In Situ

Post‐transplant lymphoproliferative disorder with cutaneous involvement: A series of four cases

Post-Transplant Lymphoproliferative Disorder, Monomorphic Type, in a Kidney Transplant Patient After Administration of Anti-Influenza Vaccine

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