Utility of head and neck biopsies in the evaluation of posttransplant lymphoproliferative disorder.
OBJECTIVE
To determine the diagnostic yield of head and neck biopsies in the evaluation of PTLD in children and to explore whether this yield was related to pretransplant Epstein-Barr virus (EBV) serostatus.


METHODS
This is a retrospective study of pediatric, post-solid-organ transplant recipients who have undergone a biopsy in the head and neck region to establish a diagnosis of PTLD.


RESULTS
Fifty-six biopsies were performed in 46 patients four to 120 months after solid-organ transplantation. Biopsies yielded PTLD in 39.1% of patients. The odds of developing PTLD if a patient was seropositive for EBV at the time of transplantation was 0.26 (95% confidence interval, 0.064-1.056; P = 0.054).


CONCLUSIONS
The high diagnostic yield of PTLD suggests that biopsies should be performed if PTLD is suspected in pediatric posttransplant patients. The results demonstrate a trend toward lower risk of PTLD among patients with pretransplant exposure to EBV.
Department of Otolaryngology--Head and Neck Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Canada. paolo.campisi@sickkids.ca
Paolo
P
Campisi
Upton D
UD
Allen
Bo-Yee
BY
Ngan
Michael
M
Hawkes
Vito
V
Forte
D000293:Adolescent; D001706:Biopsy / Q000379:methods*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D006257:Head; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008232:Lymphoproliferative Disorders / Q000175:diagnosis* / Q000821:virology*; D008297:Male; D009333:Neck; D016377:Organ Transplantation / Q000009:adverse effects*; D012307:Risk Factors; D018709:Statistics, Nonparametric