title: Necrotic, ulcerative bronchitis, the presenting feature of lymphoproliferative disease following heart-lung transplantation.
abstract: 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.
authors.affiliation: North West Lung Centre, Wythenshawe Hospital, Manchester, UK.
authors.forename: J J
authors.initials: JJ
authors.lastname: Egan
authors.forename: P S
authors.initials: PS
authors.lastname: Hasleton
authors.forename: N
authors.initials: N
authors.lastname: Yonan
authors.forename: A N
authors.initials: AN
authors.lastname: Rahman
authors.forename: A K
authors.initials: AK
authors.lastname: Deiraniya
authors.forename: K B
authors.initials: KB
authors.lastname: Carroll
authors.forename: A A
authors.initials: AA
authors.lastname: Woodcock
mesh_terms: 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