Deciphering Deception: Pancreatic Mass Presenting as Post-Transplant Lymphoproliferative Disorder
Year: 2025
Type: article
Study design: Case Report
Abstract: ABSTRACT Post-transplant lymphoproliferative disorder (PTLD) represents a spectrum of lymphoid proliferations occurring in immunocompromised transplant recipients, often associated with Epstein-Barr virus (EBV). PTLD frequently manifests at extranodal sites, posing diagnostic challenges due to its variable clinical presentation and potential mimicry of other malignancies. Here, we report a rare case of PTLD presenting as a pancreatic mass in a 68-year-old renal transplant recipient, who exhibited progressive gastrointestinal symptoms including nausea, vomiting, and jaundice. Initial imaging revealed a pancreatic head mass and extensive lymphadenopathy. Although an initial lymph node biopsy was inconclusive, endoscopic ultrasound-guided biopsy of the pancreatic mass confirmed diffuse large B-cell lymphoma, specifically activated B-cell type, indicating monomorphic PTLD. The patient's management included immunosuppression reduction and initiation of mini-R-CHOP chemotherapy. This case highlights the atypical PTLD presentation involving atypical sites such as the pancreas, emphasizing the need for persistent clinical suspicion and comprehensive diagnostic evaluation in post-transplant patients. Early recognition and a multidisciplinary approach to treatment are vital to optimizing outcomes in patients with PTLD presenting with atypical gastrointestinal manifestations.
Source: ACG Case Reports Journal
Authors: Shivangini Duggal, Monica Botros, Swati Mahapatra, Keith Garrison, Yacoub Basel, Nawar Hakim, Marc J. Zuckerman, Ricardo Badillo
Institution: Texas Tech University Health Sciences Center
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4409163877