Purpose or Case Report: 1. To establish the role of imaging in diagnosing the atypical/unexpected cases of post transplant lymphoproliferative disorder in Pediatric population.
2. To review the role of Radiology Imaging in staging, treatment monitoring and predicting the prognosis in Pediatric PTLD.
Methods & Materials: We did a retrospective analysis of some of the atypical presentations-both clinical and radiological in the patients of PTLD.
We will present the case scenarios and share the established guidelines to approach the management of such patients.
Results: PTLD is a well-recognized complication following organ transplantation ranging from abnormal lymphoid hyperplasias to frank neoplasias. The clinical presentation is not specific, and almost any organ can be affected. The disease may involve the lymph nodes or may be extra nodal. It could present as a limited disease or could be widespread. Early diagnosis is associated with a better prognosis and disease extent is an important prognostic factor that may affect therapy. The median time of onset is almost 5 years after transplantation in adult population, which is not necessarily true in the pediatric population. Treatment monitoring is equally important for initiating the patient management. Detection of the extra nodal disease is more challenging on the conventional imaging.
We would present atypical presentations of the pathologically proven PTLD in patients who had undergone various organ transplants including heart, lung,renal and liver. We would evaluate the change in patient management influenced by imaging. We would determine if there are any confounding factors of post treatment inflammatory changes in determining the response to the therapy.
Conclusions: Presentation in the pediatric age group is varied. There is potential threat of missing this malignant pathology.Radiology plays an important role in establishing early diagnosis in patients of PTLD. Crucial steps and a meticulous approach can improve the management and survival of the pediatric patients of PTLD.