Abstract
The patient was a 64-year-old man who underwent partial liver transplantation from living donor for alcoholic decompensated cirrhosis in May 2009. Both recipient and donor had prior infection with Epstein-Barr virus (EBV). After the transplantation, Triple-drug immunosuppressive therapy was performed, and the administration of the steroid was withdrawn at 6 months after the transplantation. In January 2014, he developed hematemesis and melena. Esophagogastroduodenoscopy revealed a tumorous lesion with ulcer at the upper body of the stomach. A biopsy was performed, and she was diagnosed with post-transplant lymphoproliferative disorder (PTLD). EBV-PCR test was negative. PET-CT scan showed abnormal uptake of FDG in the stomach and the swelling lymph nodes. His clinical stage was Stage II in the Ann Arbor classification. We started treatments by decreasing the doses of immunosuppressive agents, followed by chemotherapy, for that Complete response was achieved.
Almost all PTLD cases in pediatric patients of liver transplantation are EBV-positive, but in adult patients only 70% of PTLD cases are positive for EBV. Hence we have to pay attention to the possibility of EBV-negative PTLD in adult cases of liver transplantation.
