title: Gastrointestinal post-transplant lymphoproliferative disorder with rapidly forming characteristic lesions after cord blood transplantation: a report of two cases.
abstract: Epstein-Barr virus (EBV)-related post-transplant lymphoproliferative disorder (PTLD) frequently involves the gastrointestinal tract, but the endoscopic characteristics of this condition have not been discussed in detail. We report two cases of EBV-related PTLD involving rapidly forming characteristic lesions. Case 1 was a 60-year-old man with acute myeloid leukemia who underwent cord blood transplantation (CBT) after which he initially achieved complete remission (CR). He developed nausea and vomiting on day 99. Gastrointestinal endoscopy showed no tumor-like lesions in his stomach. However, a second endoscopic evaluation, which was performed 7 days after the first, revealed multiple raised lesions in his stomach, and a histopathological examination of the biopsy specimen resulted in a diagnosis of EBV-related PTLD. Case 2 was a 36-year-old man with acute myeloid leukemia who underwent CBT after achieving his second CR. He suffered nausea and pharyngalgia on day 309. Although the initial gastrointestinal endoscopic examination showed only multiple erosive or small ulcerative lesions, a second endoscopic evaluation, which was performed 10 days after the first, revealed a raised lesion with a central ulcer in the duodenum. Histopathological examination of the biopsy specimen yielded a diagnosis of EBV-related PTLD. Both patients were successfully treated by reducing the dose of immunosuppressive agents and administering rituximab.
authors.affiliation: Department of General Internal Medicine, Saiseikai Central Hospital.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sato
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sumi
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Ueki
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kaiume
authors.forename: Takehiko
authors.initials: T
authors.lastname: Kirihara
authors.forename: Wataru
authors.initials: W
authors.lastname: Takeda
authors.forename: Taro
authors.initials: T
authors.lastname: Kurihara
authors.forename: Keijiro
authors.initials: K
authors.lastname: Sato
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hiroshima
authors.forename: Kojiro
authors.initials: K
authors.lastname: Tokutake
authors.forename: Takefumi
authors.initials: T
authors.lastname: Kimura
authors.forename: Masahide
authors.initials: M
authors.lastname: Watanabe
authors.forename: Hikaru
authors.initials: H
authors.lastname: Kobayashi
mesh_terms: D000328:Adult; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis; D005312:Fetal Blood; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000821:virology; D004854:Herpesvirus 4, Human; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008232:Lymphoproliferative Disorders / Q000175:diagnosis* / Q000209:etiology / Q000821:virology; D008297:Male; D008875:Middle Aged