title: Necrotic adenoids in post-transplant lymphoproliferative disorders.
abstract: OBJECTIVE
  Post-transplant lymphoproliferative disorders (PTLD) are a potentially fatal complication after solid organ transplantation. The majority of cases are associated with Epstein Barr virus infection (EBV). The first manifestations of PTLD are frequently observed in the ENT area with adenoidal and/or tonsillar enlargement.
  
  
  METHODS
  We present the case of a 12-year old girl with a total nasal obstruction and tonsillitis five months after a kidney transplantation for bilateral congenital kidney hypoplasia.
  
  
  RESULTS
  The EBV genome was detected by polymerase reaction three months after surgery. Fiberoptic examination revealed an obstructive necrotic mass in the naso-pharynx. The anatomic-pathologic analysis revealed necrotic adenoids.
  
  
  CONCLUSIONS
  Necrotic tonsillitis is common. Necrosis of the adenoids, although rarer, can also occur and explains the important respiratory distress. Since two thirds of PTLD patients present with clinical symptoms in the ENT area, the otorhinolaryngologist should be aware of this complication.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, University Children's Hospital Queen Fabiola, Free University of Brussels, Belgium. lspinato@ulb.ac.be
authors.forename: L
authors.initials: L
authors.lastname: Spinato
authors.forename: P
authors.initials: P
authors.lastname: Brihaye
authors.forename: A
authors.initials: A
authors.lastname: De Ganseman
authors.forename: T
authors.initials: T
authors.lastname: Marquet
authors.forename: A L
authors.initials: AL
authors.lastname: Mansbach
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage; D000234:Adenoids / Q000473:pathology*; D000998:Antiviral Agents / Q000008:administration & dosage; D002648:Child; D020031:Epstein-Barr Virus Infections / Q000276:immunology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007244:Infectious Mononucleosis / Q000276:immunology* / Q000821:virology; D016030:Kidney Transplantation / Q000276:immunology; D008279:Magnetic Resonance Imaging; D015508:Nasal Obstruction / Q000473:pathology / Q000821:virology*; D009336:Necrosis; D016720:Pneumocystis Infections / Q000276:immunology
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir