title: Fatal sclerosing peritonitis associated with primary effusion lymphoma after liver transplantation: a case report.
abstract: Sclerosing peritonitis (SP) after liver transplantation has been described in 10 cases in the literature. The etiology is still unknown; however, SP is considered a consequence of chronic irritation and inflammation. It can be classified as primary (idiopathic) or secondary form. Although pathologically benign, it has a negative course, resulting in unrelenting abdominal pain, small bowel obstruction, malnutrition, and death. Posttransplantation lymphoproliferative disease (PTLD) is one of the leading causes of late death. Its development is related to complex interactions between immunosuppressive drugs and environmental agents. Primary effusion lymphoma (PEL) as an onset presentation of PTLD is relatively uncommon. Most examples of effusion-based PTLD have been secondary to widespread solid organ involvement and associated with Human herpes virus 8 (HHV-8) recurrence. Here in, we report a case of a 55-year-old man who rapidly developed refractory ascites and bacterial peritonitis at 1-year after orthotopic liver transplantation (OLT) with a fatal clinical course at the beginning of the second follow-up year after an uncomplicated liver transplantation due to cryptogenic cirrhosis. The diagnosis of HHV-8-positive lymphoma was established by postmortem examination with multiple solid localizations and massive dense fibrotic adhesions encompassing the small intestine, colon, liver, and porta hepatis without any involvement of body cavities.
authors.affiliation: Department of Infectious Diseases, I Division, INMI-IRCCS L. Spallanzani, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Testa
authors.forename: A
authors.initials: A
authors.lastname: Baiocchini
authors.forename: U V
authors.initials: UV
authors.lastname: Comandini
authors.forename: L
authors.initials: L
authors.lastname: Falasca
authors.forename: R
authors.initials: R
authors.lastname: Nardacci
authors.forename: M
authors.initials: M
authors.lastname: Maritti
authors.forename: L
authors.initials: L
authors.lastname: Loiacono
authors.forename: C
authors.initials: C
authors.lastname: Bibbolino
authors.forename: E B
authors.initials: EB
authors.lastname: Rizzi
authors.forename: M
authors.initials: M
authors.lastname: Cristofaro
authors.forename: G M
authors.initials: GM
authors.lastname: Ettorre
authors.forename: G
authors.initials: G
authors.lastname: Vennarecci
authors.forename: G
authors.initials: G
authors.lastname: Antonucci
authors.forename: F
authors.initials: F
authors.lastname: Del Nonno
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D001201:Ascites / Q000209:etiology; D001344:Autopsy; D004064:Digestive System / Q000473:pathology; D017809:Fatal Outcome; D005355:Fibrosis; D019288:Herpesvirus 8, Human / Q000302:isolation & purification; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D054685:Lymphoma, Primary Effusion / Q000209:etiology* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D010538:Peritonitis / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D012598:Sclerosis