Posttransplantation Lymphoproliferative Disorder Initially Seen as Iris Mass and Uveitis

Abstract

rimary ocular posttransplantation lymphoproliferative disorder is rare. Epstein-Barr virus is implicated as the cause as a result of systemic immunosuppression after transplant surgery. We studied a patient who developed ocular posttransplantion lymphoproliferative disorder after orthotopic liver transplantation. Slitlamp and light microscopic photographs confirmed the diagnosis.

EBV-induced polymorphic lymphoproliferative disorder of the iris after heart transplantation

“…However, in some cases the differentiation between PTLD and lymphoma still can be very difficult. PTLD may clinically occur in three distinct forms [1,7,21,23,24]. The first variant is a circumscribed lesion like in our patient, which typically presents later than 1 year after transplantation.…”

“…Thus, the iris clearly is the predilection site of intraocular PTLD. With conventional ultrasound examination PTLD seems to be limited to the iris in the majority of the cases [5,7]. However, to the best of our knowledge, UBM ultrasound examination has not been performed as yet in iris PTLD so that an additional ciliary body infiltration cannot be ruled out with certainty.…”

“…Posttransplantation lymphoproliferative disorder (PTLD) can be observed in all age groups after transplantation of the kidney, liver, heart, lung, or bone marrow [17]. Taking all solid organ transplants together, the incidence of PTLD is approximately 2-3% [2,3,7,14,17,23]. However, kidney recipients are at a lower risk than heart or lung recipients due to the different immunosuppression regimens [14,17,24].…”

“…Besides keratic precipitates and anterior chamber cells, there is a uni-or bilateral, flesh-colored iris mass that may show prominent vessels [1,3,5,7,14,18] (Figs. 1, 2, 3).…”

Iris nodules associated with infectious uveitis

“…Associated with Epstein-Barr virus exposure after organ transplantation. [35][36][37] Lymphoma and leukaemia Seen in cases of systemic malignancy. May have hypopyon uveitis.…”