Necrotic, ulcerative bronchitis, the presenting feature of lymphoproliferative disease following heart-lung transplantation.
Following heart-lung transplantation two of 21 patients who survived more than 100 days developed post-transplant lymphoproliferative disease. Both presented with localised ulcerative bronchitis documented at flexible bronchoscopy four months after transplantation. Histological examination showed necrosis with acute inflammation and ulceration. Case 2 demonstrated lymphoproliferative disease from biopsies subsequently taken at rigid bronchoscopy. Case 1 later developed lung nodules and a monoclonal high grade B cell non-Hodgkin's lymphoma was confirmed by an open lung biopsy. The bronchoscopic features described should alert clinicians to post-transplant lymphoproliferative disease as an underlying diagnosis and suggest that bronchus associated lymphoid tissue is the initial site for clonal proliferation in the disease.
Egan
J J
JJ
North West Lung Centre, Wythenshawe Hospital, Manchester, UK.
Hasleton
P S
PS
Yonan
N
N
Rahman
A N
AN
Deiraniya
A K
AK
Carroll
K B
KB
Woodcock
A A
AA
D000328:Adult; D001991:Bronchitis / Q000209:etiology*; D005260:Female; D016041:Heart-Lung Transplantation; D006801:Humans; D016393:Lymphoma, B-Cell / Q000209:etiology; D008232:Lymphoproliferative Disorders / Q000209:etiology*; D008875:Middle Aged; D009336:Necrosis; D011183:Postoperative Complications; D014456:Ulcer / Q000209:etiology