Colonic Diffuse Large B-Cell Lymphoma in a Liver Transplant Patient with Historically Very Low Tacrolimus Levels
Posttransplant lymphoproliferative disorders (PTLDs) comprise a wide spectrum of hematologic malignancies that are found increasingly in orthotopic liver transplant (OLT) patients given the rising frequency of these surgeries and their long-term success. PTLDs are highly correlated with both the Eps...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2012/952359 |
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| author | Christopher M. Moore Ihab Lamzabi Anne K. Bartels Shriram Jakate David H. Van Thiel |
| author_facet | Christopher M. Moore Ihab Lamzabi Anne K. Bartels Shriram Jakate David H. Van Thiel |
| author_sort | Christopher M. Moore |
| collection | DOAJ |
| description | Posttransplant lymphoproliferative disorders (PTLDs) comprise a wide spectrum of hematologic malignancies that are found increasingly in orthotopic liver transplant (OLT) patients given the rising frequency of these surgeries and their long-term success. PTLDs are highly correlated with both the Epstein-Barr virus (EBV) infection and the degree of immunosuppression involved. Herein is reported a case of a 53-year-old male with successfully treated hepatitis C virus genotype 4 and hepatocellular carcinoma who underwent OLT and developed symptoms of weakness and poor appetite 4 years later while on tacrolimus 3 mg b.i.d. with historically very low plasma levels. He was found to be anemic and colonoscopy revealed a 4.5 cm cecal diffuse large B-cell lymphoma (DLBCL). Further workup revealed mesenteric lymph node enlargement consistent and nodal DLBCL dissemination. He was treated with cyclophosphamide-hydroxyldaunorubicin-oncovin-prednisone-rituximab (CHOP-R) chemotherapy and his tacrolimus dose was lowered. Additionally, he manifested PTLD-associated cryoglobulinemia leading to acute kidney injury. After a prolonged hospitalization he was discharged with close followup. |
| format | Article |
| id | doaj-art-913fb5efecae4cf59675516e2f90b074 |
| institution | OA Journals |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-913fb5efecae4cf59675516e2f90b0742025-08-20T02:09:43ZengWileyCase Reports in Transplantation2090-69432090-69512012-01-01201210.1155/2012/952359952359Colonic Diffuse Large B-Cell Lymphoma in a Liver Transplant Patient with Historically Very Low Tacrolimus LevelsChristopher M. Moore0Ihab Lamzabi1Anne K. Bartels2Shriram Jakate3David H. Van Thiel4Section of Hepatology, Rush University Medical Center, Chicago, IL 60612, USASection of Pathology, Rush University Medical Center, Chicago, IL 60612, USASection of Hepatology, Rush University Medical Center, Chicago, IL 60612, USASection of Pathology, Rush University Medical Center, Chicago, IL 60612, USASection of Hepatology, Rush University Medical Center, Chicago, IL 60612, USAPosttransplant lymphoproliferative disorders (PTLDs) comprise a wide spectrum of hematologic malignancies that are found increasingly in orthotopic liver transplant (OLT) patients given the rising frequency of these surgeries and their long-term success. PTLDs are highly correlated with both the Epstein-Barr virus (EBV) infection and the degree of immunosuppression involved. Herein is reported a case of a 53-year-old male with successfully treated hepatitis C virus genotype 4 and hepatocellular carcinoma who underwent OLT and developed symptoms of weakness and poor appetite 4 years later while on tacrolimus 3 mg b.i.d. with historically very low plasma levels. He was found to be anemic and colonoscopy revealed a 4.5 cm cecal diffuse large B-cell lymphoma (DLBCL). Further workup revealed mesenteric lymph node enlargement consistent and nodal DLBCL dissemination. He was treated with cyclophosphamide-hydroxyldaunorubicin-oncovin-prednisone-rituximab (CHOP-R) chemotherapy and his tacrolimus dose was lowered. Additionally, he manifested PTLD-associated cryoglobulinemia leading to acute kidney injury. After a prolonged hospitalization he was discharged with close followup.http://dx.doi.org/10.1155/2012/952359 |
| spellingShingle | Christopher M. Moore Ihab Lamzabi Anne K. Bartels Shriram Jakate David H. Van Thiel Colonic Diffuse Large B-Cell Lymphoma in a Liver Transplant Patient with Historically Very Low Tacrolimus Levels Case Reports in Transplantation |
| title | Colonic Diffuse Large B-Cell Lymphoma in a Liver Transplant Patient with Historically Very Low Tacrolimus Levels |
| title_full | Colonic Diffuse Large B-Cell Lymphoma in a Liver Transplant Patient with Historically Very Low Tacrolimus Levels |
| title_fullStr | Colonic Diffuse Large B-Cell Lymphoma in a Liver Transplant Patient with Historically Very Low Tacrolimus Levels |
| title_full_unstemmed | Colonic Diffuse Large B-Cell Lymphoma in a Liver Transplant Patient with Historically Very Low Tacrolimus Levels |
| title_short | Colonic Diffuse Large B-Cell Lymphoma in a Liver Transplant Patient with Historically Very Low Tacrolimus Levels |
| title_sort | colonic diffuse large b cell lymphoma in a liver transplant patient with historically very low tacrolimus levels |
| url | http://dx.doi.org/10.1155/2012/952359 |
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