1. Post-transplantation primary central nervous system lymphoma in a patient with systemic lupus erythematosus and prolonged use of immunosuppressant
- Author
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Y C Po, Tony K T Chan, Allan N L Chan, and Teresa P K Tse
- Subjects
Adult ,medicine.medical_specialty ,Pathology ,Weakness ,Lymphoma ,Organ transplantation ,Diagnosis, Differential ,Lesion ,Postoperative Complications ,medicine ,Humans ,Lupus Erythematosus, Systemic ,Abscess ,Brain Neoplasms ,business.industry ,Incidence (epidemiology) ,Primary central nervous system lymphoma ,General Medicine ,medicine.disease ,Kidney Transplantation ,Post transplant ,Frontal Lobe ,Female ,Histopathology ,medicine.symptom ,business ,Immunosuppressive Agents - Abstract
Post-transplantation primary central nervous system lymphoma is an uncommon and fatal post-transplant lymphoproliferative disorder. Such lymphomas have been described in only a few case series in the literature. The incidence of this condition is rising with improved survival after organ transplantation. A case of post-transplantation primary central nervous system lymphoma in a young Chinese woman with systemic lupus erythematosus is described here. She presented with right-sided weakness and memory loss after tooth extraction 2 weeks before admission. Contrast computed tomography of the brain demonstrated a contrast rim-enhancing lesion over the left frontal lobe. With a history of recent dental procedure, long-term immunosuppressive therapy and computed tomography findings, cerebral abscess was highly suspected. Emergency operation was performed. Histopathology showed post-transplantation primary central nervous system lymphoma, with cells positive for B-cell marker CD20. Immunosuppressant was stopped and she was treated with radiotherapy and rituximab (anti-CD20 monoclonal antibody). She remained disease-free at 16 months. Post-transplantation primary central nervous system lymphoma is rare with variable presentation and radiological features. We believe rituximab may have a role in the treatment of such lymphomas.
- Published
- 2014
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