Contrast-enhanced ultrasound findings of post-transplant lymphoproliferative disorder in a transplanted kidney: A case report and literature review

摘要

Post-transplant lymphoproliferative disorder occurs in approximately one percent of kidney transplant recipients. We evaluated a seventy-seven year-old man with a solid mass in his transplant kidney. On contrast enhanced ultrasound, the mass enhanced but remained persistently hypovascular throughout exam. The enhancement pattern of the mass differed from that typical of clear cell renal cell carcinoma, the main differential diagnosis. Final pathology after partial nephrectomy confirmed post-transplant lymphoproliferative disorder. This is the first report of contrast enhanced ultrasound findings in a renal mass diagnosed as post-transplant lymphoproliferative disorder. Contrast enhanced ultrasound has a promising role in imaging of renal masses, particularly relevant in transplant patients due to the lack of nephrotoxicity. Keywords: Contrast enhanced ultrasound, renal transplant, lymphoma, post-transplant lymphoproliferative disorderCASE REPORTA seventy-seven year-old Hispanic male presented nine years after renal transplant in a hypertensive crisis. Non-enhanced computed tomography (NECT) showed a solid, centrally hypodense renal mass measuring approximately 3 cm in the lower pole of the transplanted kidney (Figure 1). The patient’s renal function precluded contrast-enhanced computed tomography (CECT). Open in a separate windowFigure 1 Seventy-seven year-old man with post-transplant lymphoproliferative disorder.Findings: Axial (A), coronal (B), and sagittal (C) images show a round, centrally hypodense, 3 cm mass at the lower pole of the transplant kidney (arrow).Technique: Noncontrast CT of the abdomen and pelvis (Scanner: Multidetector CT Siemens Sensation 16-slice?.Protocol: 212mAs, 120kV, 3mm slice thickness).