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ACUTE AIRWAY OBSTRUCTION: AN UNUSUAL PRESENTATION OF POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER IN A RENAL TRANSPLANT RECIPIENT

JYOTİ AGGARWAL, DOLA JASWANTH KUMAR, VİNAY RATHORE, RUPA MEHTA, AMİT KUMAR, MUDALSHA RAVİNA

Experimental and Clinical Transplantation - 2024;22(4):307-310

 

Posttransplant lymphoproliferative disorder is a life-threatening complication after solid-organ transplants. In adults, recipients of heart transplants have the highest risk, whereas renal transplant recipients have the lowest risk among all solid-organ transplants. The most common site for posttransplant lymphoproliferative disorders are gastrointestinal tract followed by the graft itself. Airway involvement in posttransplant lymphoproliferative disorder is rarely encountered. We report a case of a 26-year-old renal allograft recipient who presented to the emergency room with airway obstruction necessitating an emergency tracheostomy. Imaging revealed a left tonsillar mass extending into the nasopharynx and retropharyngeal space causing complete orop-haryngeal occlusion. Endoscopic biopsy from nasopharyngeal mass showed a diffuse large B-cell lymphoma and was Ebstein-Barr virus positive. Reduction in immunosuppression and treatment with posttransplant lymphoproliferative disorder-1 risk-stratified approach resulted in complete remission.