{"title":"[活体肝移植 14 年后的一例原发性中枢神经系统移植后淋巴增生性疾病】。]","authors":"Hiroaki Otsuka, Tomoaki Shima, Koichi Yoshida, Hirokazu Kurohama, Akira Tsujino","doi":"10.5692/clinicalneurol.cn-001991","DOIUrl":null,"url":null,"abstract":"<p><p>The patient was a 51-year-old man who had undergone living donor liver transplantation for type B cirrhosis at the age of 37 years, and had a history of immunosuppressive drug use. He had developed focal seizures starting from his right upper limb, and MRI showed a lesion in the subcortical white matter of his left parietal lobe. Sensory disturbance and paralysis progressed in his right upper and lower limbs, and his brain lesion rapidly enlarged. A brain biopsy revealed diffuse large B-cell lymphoma, and Epstein-Barr virus-encoded small RNA in situ hybridization was positive. The patient was diagnosed with primary central nervous system post-transplant lymphoproliferative disorder (PCNS-PTLD) with no lesions in other organs. There are few reports of PCNS-PTLD cases after living donor liver transplantation in Japan. Although rare, it is nevertheless important to consider this disease in patients receiving immunosuppressive drugs after organ transplantation who develop brain lesions, regardless of which organ was transplanted.</p>","PeriodicalId":39292,"journal":{"name":"Clinical Neurology","volume":" ","pages":"794-801"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[A case of primary central nervous system post-transplant lymphoproliferative disease 14 years after living donor liver transplantation].\",\"authors\":\"Hiroaki Otsuka, Tomoaki Shima, Koichi Yoshida, Hirokazu Kurohama, Akira Tsujino\",\"doi\":\"10.5692/clinicalneurol.cn-001991\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The patient was a 51-year-old man who had undergone living donor liver transplantation for type B cirrhosis at the age of 37 years, and had a history of immunosuppressive drug use. He had developed focal seizures starting from his right upper limb, and MRI showed a lesion in the subcortical white matter of his left parietal lobe. Sensory disturbance and paralysis progressed in his right upper and lower limbs, and his brain lesion rapidly enlarged. A brain biopsy revealed diffuse large B-cell lymphoma, and Epstein-Barr virus-encoded small RNA in situ hybridization was positive. The patient was diagnosed with primary central nervous system post-transplant lymphoproliferative disorder (PCNS-PTLD) with no lesions in other organs. There are few reports of PCNS-PTLD cases after living donor liver transplantation in Japan. Although rare, it is nevertheless important to consider this disease in patients receiving immunosuppressive drugs after organ transplantation who develop brain lesions, regardless of which organ was transplanted.</p>\",\"PeriodicalId\":39292,\"journal\":{\"name\":\"Clinical Neurology\",\"volume\":\" \",\"pages\":\"794-801\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-11-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Neurology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5692/clinicalneurol.cn-001991\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5692/clinicalneurol.cn-001991","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/19 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
患者是一名 51 岁的男性,37 岁时因 B 型肝硬化接受了活体肝移植手术,并有使用免疫抑制剂的病史。他从右上肢开始出现局灶性癫痫发作,核磁共振成像显示其左顶叶皮质下白质出现病变。他的右上肢和右下肢出现感觉障碍和瘫痪,脑部病变迅速扩大。脑活检发现了弥漫大B细胞淋巴瘤,Epstein-Barr病毒编码的小RNA原位杂交呈阳性。患者被诊断为原发性中枢神经系统移植后淋巴组织增生性疾病(PCNS-PTLD),其他器官无病变。在日本,活体肝移植后出现 PCNS-PTLD 病例的报道很少。虽然罕见,但对于器官移植后接受免疫抑制药物治疗并出现脑部病变的患者,无论移植的是哪个器官,都必须考虑这种疾病。
[A case of primary central nervous system post-transplant lymphoproliferative disease 14 years after living donor liver transplantation].
The patient was a 51-year-old man who had undergone living donor liver transplantation for type B cirrhosis at the age of 37 years, and had a history of immunosuppressive drug use. He had developed focal seizures starting from his right upper limb, and MRI showed a lesion in the subcortical white matter of his left parietal lobe. Sensory disturbance and paralysis progressed in his right upper and lower limbs, and his brain lesion rapidly enlarged. A brain biopsy revealed diffuse large B-cell lymphoma, and Epstein-Barr virus-encoded small RNA in situ hybridization was positive. The patient was diagnosed with primary central nervous system post-transplant lymphoproliferative disorder (PCNS-PTLD) with no lesions in other organs. There are few reports of PCNS-PTLD cases after living donor liver transplantation in Japan. Although rare, it is nevertheless important to consider this disease in patients receiving immunosuppressive drugs after organ transplantation who develop brain lesions, regardless of which organ was transplanted.