PMC4891579_01
CT one year after transplant showing several new masses within the renal allograft. [Powerpoint Slide]
gr1.jpg
PMC4891579_01_gr1.jpg
fig1
The next CT exam at one year post transplant, revealed several masses within the allograft (Figure 1), which appeared solid by ultrasound examination.
CT images at the level of a left lobe liver metastasis (arrow) and small incidental cyst (arrowhead). A. At 15 months after transplant B. At 30 months after transplant with decreasing size and central calcification within the metastasis.C. At 42 months after transplant with complete calcification of the metastasis. [Powerpoint Slide]
gr2b.jpg
PMC4891579_01_gr2b.jpg
fig2
The first hepatic metastasis visible on CT (Figure 2a), in the lateral left lobe, was seen at the first three month follow-up, after the allograft nephrectomy (approximately 15 months after the transplant.) Other metastases became visible later (Figure 3a). As these metastases were followed with CT, they eventually became calcified and smaller, consistent with remission/rejection (Figure 2, Figure 3).
CT images showing a periportal metastasis (arrow) and a peripheral metastasis (arrowhead). A. At 18 months after transplant. B. At 30 months after transplant showing increased size of the periportal metastasis with rim calcification. Peripheral metastasis now present with calcification. C. At 42 months after transplant showing decreased size and increased rim calcification of the periportal metastasis. Peripheral metastasis now completely calcified. [Powerpoint Slide]
gr3.jpg
PMC4891579_01_gr3.jpg
fig3
The first hepatic metastasis visible on CT (Figure 2a), in the lateral left lobe, was seen at the first three month follow-up, after the allograft nephrectomy (approximately 15 months after the transplant.) Other metastases became visible later (Figure 3a). As these metastases were followed with CT, they eventually became calcified and smaller, consistent with remission/rejection (Figure 2, Figure 3).
Microscopic image showing residual melanin in the liver (arrowhead) surrounded by scarring, but no residual malignancy. Adjacent normal liver (arrow). B. In parts of the specimen, the melanin (brown) was abundant. [Powerpoint Slide]
gr4.jpg
PMC4891579_01_gr4.jpg
fig4
A biopsy of one of the hepatic metastases was performed approximately 3.5 years after the allograft nephrectomy and cessation of immunosuppressive therapy, showing abundant melanin pigment, but no malignancy (Figure 4).