title: Native lung pneumonectomy for post-transplantation lymphoproliferative disorder refractory to rituximab following contralateral lung transplantation.
abstract: Post-transplantation lymphoproliferative disorder (PTLD) is a life-threatening complication following lung transplantation. We report a PTLD case of high-grade, B-cell lymphoma following contralateral single-lung transplantation. The disease involved the liver, right kidney and right native lung. While the PTLD affecting the abdominal organs regressed with rituximab chemotherapy, the native lung disease progressed and was treated surgically (right pneumonectomy). Some aspects are unique in this case: (i) different response to medical treatment between lung and abdominal organs; (ii) absolute absence of involvement of the native lung and (iii) surgical treatment with a pneumonectomy, still very rarely described in the literature. We hypothesized that a different morphotype of the disease involved the abdominal organs or the penetrance of rituximab, and chemotherapy could have been impaired by the presence of pulmonary fibrosis.
authors.affiliation: Department of Thoracic Surgery, Papworth Hospital, Cambridge, UK mariusroman@nhs.net.
authors.forename: Marius
authors.initials: M
authors.lastname: Roman
authors.affiliation: Department of Cardiothoracic Transplantation, Papworth Hospital, Cambridge, UK.
authors.forename: Jasvir
authors.initials: J
authors.lastname: Parmar
authors.affiliation: Department of Histopathology, Papworth Hospital, Cambridge, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Goddard
authors.affiliation: Department of Thoracic Surgery, Papworth Hospital, Cambridge, UK.
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Solli
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D012086:Reoperation; D000069283:Rituximab / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D000069283:Rituximab
keywords: Lung transplantation; Native Lung; Pneumonectomy; Post-transplantation lymphoproliferative disease; Rituximab