Primary Central Nervous System Post–transplant Lymphoproliferative Disorder Misdiagnosed as Glioblastoma: A Case Report

Tanaka, Haku; MATSUDA, RYOSUKE; NAKAMURA, MITSUTOSHI; Nakagawa, Ichiro; Nakase, Hiroyuki

doi:10.21873/anticanres.15893

Cited by 3 publications

(4 citation statements)

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“…9 ). Other reported enhancement patterns include heterogenous and solid/homogenous enhancement [9 , 39 , 49] . The enhancement pattern has also been linked to lesion size.…”

Section: Discussionmentioning

confidence: 99%

“…Glial tumors usually present as a solitary lesion but can be multifocal up to 33% of cases [1] . To illustrate the overlap in imaging appearance between diffuse astrocytoma wild type and CNS-PTLD, Tanaka et al reported a case of CNS-PTLD that presented as a single, enhancing lesion in the corpus callosum and was initially misdiagnosed as grade IV astrocytoma [49] .…”

Section: Discussionmentioning

confidence: 99%

“…6 A PRISMA flowchart of our screening and review process. [2 , 3 , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , 38 , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [51] , [52] , [53] , [54] , 57 , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , …”

Section: Methodsunclassified

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Primary central nervous system post-transplantation lymphoproliferative disorder: A case report and systematic review of imaging findings

Hoyt,

Hughes,

Liu

et al. 2024

Radiology Case Reports

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“…9 ). Other reported enhancement patterns include heterogenous and solid/homogenous enhancement [9 , 39 , 49] . The enhancement pattern has also been linked to lesion size.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsunclassified

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Primary central nervous system post-transplantation lymphoproliferative disorder: A case report and systematic review of imaging findings

Hoyt,

Hughes,

Liu

et al. 2024

Radiology Case Reports

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“…CT scans may show various changes, including high, moderate, and low-density alterations ( 33 ). Because PCNS-PTLD patients do not exhibit specific enhancements on CT and MRI scans ( 17 ), the presence of supratentorial ring enhancement on MRI, while highly suggestive of PCNS-PTLD, does not exclude other diseases. Definitive diagnosis relies on histopathological biopsy.…”

Section: Discussionmentioning

confidence: 99%

A disease warranting attention from neurosurgeons: primary central nervous system post-transplant lymphoproliferative disorder

Jin,

Lu,

Yan

et al. 2024

Front. Neurol.

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BackgroundPrimary central nervous system post-transplant lymphoproliferative disorder (PCNS-PTLD) is a rare condition, posing diagnostic and treatment challenges, with histological biopsy essential for diagnosis. Standardized treatment protocols are lacking. This disease requires urgent attention due to the increasing number of organ transplant surgeries and the use of immunosuppressive agents.MethodsFrom 2020 to 2023, our center diagnosed five patients with PCNS-PTLD. We reviewed their clinical records and conducted a comprehensive analysis of 22 literatures on PCNS-PTLD cases following renal transplantation or allogeneic hematopoietic stem cell transplantation (HSCT).ResultsFour patients had previously received a kidney transplant, one had undergone allogeneic HSCT. The median time from the last transplant surgery to the diagnosis of PCNS-PTLD differs between kidney transplant (21.5 years) and allogeneic HSCT (9 months). Common symptoms included motor weakness (n = 4), headache (n = 2), confusion (n = 2), and nausea (n = 2), with ring-enhancing (n = 5), typically solitary (n = 3) and supratentorial (n = 3) lesions on imaging. Diagnosis involved robot-assisted stereotactic brain biopsy (n = 4) or craniotomy (n = 1), all showing Epstein-Barr virus and CD20 positivity. Most cases (n = 4) were monomorphic diffuse large B-cell lymphoma. Treatment included rituximab (n = 3), surgical resection (n = 2), zanubrutinib (n = 1), whole-brain radiation (n = 1), and methotrexate (n = 1). At the last follow-up, the median duration of follow-up for all patients was 19 months. During this time, 3 patients had died and 2 patients were still alive.ConclusionIn patients with a history of kidney transplantation or allogeneic HSCT who are on long-term immunosuppressive therapy, any neurological symptoms, particularly the presence of supratentorial ring-enhancing masses in the brain on imaging, whether solitary or multiple, should raise high suspicion for this disease, warranting a timely brain biopsy. Additionally, we found that besides reducing immunosuppressants, zanubrutinib may be a potential, safe, and effective treatment for this condition. Moreover, post-surgical administration of rituximab in conjunction with whole-brain radiotherapy also appears to be a potentially safe and effective approach.

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A case of primary central nervous system post-transplant lymphoproliferative disease 14 years after living donor liver transplantation

Otsuka,

Shima,

Yoshida

et al. 2024

Rinsho Shinkeigaku

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Primary Central Nervous System Post–transplant Lymphoproliferative Disorder Misdiagnosed as Glioblastoma: A Case Report

Cited by 3 publications

References 0 publications

Primary central nervous system post-transplantation lymphoproliferative disorder: A case report and systematic review of imaging findings

Primary central nervous system post-transplantation lymphoproliferative disorder: A case report and systematic review of imaging findings

A disease warranting attention from neurosurgeons: primary central nervous system post-transplant lymphoproliferative disorder

A case of primary central nervous system post-transplant lymphoproliferative disease 14 years after living donor liver transplantation

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