Kirihetti Liyanage Neelika,  Kumbla Surekha

Final Pr. ID: Poster #: EDU-001

Post-transplant lymphoproliferative disorder (PTLD) is an important cause of morbidity and mortality which affects transplant recipients of solid organs and allogenic bone marrow transplants. Paediatric recipients of organs that require high levels of immunosuppression are the most susceptible population. Incidence and the frequency of PTLD in paediatric age group is consistently higher than it is in adults. There is insufficient recent literature on imaging features of PTLD in the paediatric age group.
Our purpose is to illustrate multi-modality imaging characteristics of PTLD affecting different organs and systems in a cohort of paediatric patients with biopsy proven PTLD. Read More

Authors:  Kirihetti Liyanage Neelika , Kumbla Surekha

Keywords:  PTLD, Transplant, Lymphadenopathy

Maddocks Alexis,  Fenlon Edward,  Chen Susie,  Ruzal-shapiro Carrie,  Jaramillo Diego

Final Pr. ID: Poster #: EDU-083

Post-Transplant Lymphoproliferative Disease (PTLD) is a polyclonal and monoclonal lymphoid proliferation which occurs in 1-20% of solid organ transplant recipients. It is most common in multivisceral organ transplants followed by small bowel transplants, heart and lung transplants and less commonly in liver and kidney transplants. PTLD has a bimodal distribution of occurrence with the largest peak occurring within 1 year after transplantation and a second peak at approximately 4-5 years after transplantation. The Epstein Barr virus (EBV) is associated in 50-70% of cases. EBV seronegativity in the recipient at the time of transplant predicts a 2-4 times increased risk of PTLD especially if they receive a donor organ which is positive for EBV. This may explain the higher incidence in the pediatric population who tend to be seronegative for EBV. The World Health Organization (WHO) identifies four pathologic categories of PTLD: early lesions, polymorphic type, monomorphic type and classic Hodgkins lymphoma. The majority of PTLD cases are caused by B-lymphocyte proliferation in a T-cell depleted environment in the setting of immunosuppression. However, there is a subset of cases that are caused by T-cell or natural killer cells as well as cases that occur in the setting of negative EBV. Multiple clones of proliferating B-cells can be seen in a single patient. 2/3 of cases have diffuse expression of CD20 which is an important target for therapy.

PTLD may be focal or diffuse and can manifest in a variety of different organ systems or even in the allograft itself. There is a higher percentage of extranodal disease in PTLD as compared to immunocompetent patients with lymphoma. The GI tract and liver are most commonly involved. Isolated lymph node involvement in comparison is less common in patients with PTLD. Central nervous system (CNS) involvement is relatively rare in PTLD.

This educational exhibit will provide a pictorial review of PTLD and illustrates cases from one of the busiest transplant centers in North America to highlight the major imaging findings as well as complications seen on imaging of this disease. Extranodal and nodal disease will be demonstrated on multiple modalities as well as complications of this disease including intussusception and biliary obstruction. CNS disease will also be shown. The clinical manifestations, imaging characteristics, prognosis and treatment will be discussed and depicted. Read More

Authors:  Maddocks Alexis , Fenlon Edward , Chen Susie , Ruzal-shapiro Carrie , Jaramillo Diego

Keywords:  PTLD

Wu Markus,  Sharma Priya,  Rajderkar Dhanashree

Final Pr. ID: Poster #: EDU-036

In this education exhibit we will review a variety of presentations of posttransplant lymphoproliferative disorder (PTLD) and review the approach to imaging these patients. We will include cases that are atypical and discuss the pitfalls in imaging this population. We will provide imaging guidelines after a review of the current literature. Read More

Authors:  Wu Markus , Sharma Priya , Rajderkar Dhanashree

Keywords:  PTLD, Transplantation, Pitfalls

Samreen Naziya,  Sharma Priya,  Tuna Ibrahim,  Rajderkar Dhanashree

Final Pr. ID: Poster #: EDU-113

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. Read More

Authors:  Samreen Naziya , Sharma Priya , Tuna Ibrahim , Rajderkar Dhanashree

Keywords:  Transplant, Lymphoproliferative, PTLD, Unexpected, Management of PTLD