Question

13 yr old girl has an episode of severe cellular rejection necessitating maximal immunosuppression 6 months after a cadaveric renal transplantation. Two weeks later, she develops lymphadenopathy and hepatosplenomegaly. Exam of lymph node tissue obtained on biopsy shows a monomorphous population of B lymphocytes. Diagnosis?

Answer 1

The likely diagnosis for the girl with lymphadenopathy and hepatosplenomegaly post-transplantation is Post-transplant lymphoproliferative disorder (PTLD), a condition that can occur due to the immunosuppression required following organ transplantation.

Step-by-step explanation:

The diagnosis for a 13-year-old girl who experienced severe cellular rejection after a cadaveric renal transplantation and developed lymphadenopathy and hepatosplenomegaly two weeks following maximal immunosuppression is likely to be Post-transplant lymphoproliferative disorder (PTLD). This condition occurs due to immunosuppression and often presents with a proliferation of monomorphous B lymphocytes, which can be observed in a biopsy. PTLD is associated with Epstein-Barr virus (EBV) infections, which can induce the transformation of B lymphocytes into malignant cells, particularly in the setting of reduced T-cell surveillance due to immunosuppression.