PMC3056220_01
CT scan of chest demonstrated multicompartmental mediastinal lymphadenopathy, for example, a right paratracheal node measuring 14 mm in short axis.
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fig1
CT of chest, abdomen, and pelvis revealed numerous lymph nodes in the mediastinum, cervical, and abdominal regions (Figure 1).
Lymph node architecture has been subtotally replaced by a diffuse proliferation of small, medium, and large lymphoid cells. (a) positive LMP-1 stain, (b) positive CD-20 antibody stain. Immunohistochemical staining with Kappa and Lambda (c and d, resp.) showed many transformed cells and was positive for plasma cells.
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fig2
Excisional lymph node biopsy of the right scalene lymph node was positive for polymorphic PTLD (Figure 2).
CT scan of chest posttreatment showed mediastinal nodes decreasing in size.
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fig3
With the reduction in immunosuppression therapy, a desired effect of lymph node size reduction was seen on CT scan 22 days later (Figure 3).
Graph indicating the EBV DNA PCR trends while on intravenous ganciclovir and foscarnet.
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fig4
This prompted a significant reduction in EBV PCR values to undetectable levels as depicted in Figure 4.