PMC6558365_01
PMC6558365_02
PMC6558365_03
PMC6558365_04
(A) Endoscopic findings of the laryngeal lesion of CD4+T-cell lymphoproliferative disease (LPD) lesion in case 4 prior to cancer chemotherapy. (B) Fluorodeoxyglucose-positron emission tomography (FDG-PET) at the onset of LPD. White arrows show the increased FDG uptake in the larynx, stomach, and terminal ileum. The maximum standardized uptake value (SUVmax) was 11.8. (C) Improvement of the laryngeal LPD lesion after bone marrow transplantation (BMT). (D) FDG-PET at the onset of donor-derived CD4+T-LPD after BMT. White arrows show the increased FDG uptake in multiple lymph nodes without laryngeal lesion. The SUVmax was 9.7.
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F1
After admission, an urgent tracheostomy prevented airway obstruction by the laryngeal mass (Figure 1A). Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed increased levels of uptake in the stomach and terminal ileum as well as the laryngeal lesion (Figure 1B). The laryngeal lesion disappeared after a compete donor chimerism was achieved (Figure 1C). However, systemic but not local proliferation of EBV-infected donor-derived CD4+ T cells (1 x 104 copies/ml of whole peripheral blood and 3 x 103 copies/mugDNA of CD4+T cells, respectively) developed 2 months posttransplantation (Figure 1D).