Post-transplant lymphoproliferative disorder presenting as epistaxis

An unusual case of epistaxis resulting from post-transplant lymphoproliferative disorder is described. A 30-year-old woman who had undergone renal transplantation 12 years previously presented with profuse, posterior, unilateral epistaxis. The initial findings, workup and treatment are presented. A...

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Bibliographic Details
Published in:Journal of laryngology and otology 2004-11, Vol.118 (11), p.906-908
Main Authors: Clarke, Jonathan D., Stock, David, Singh, Vijay
Format: Article
Language:English
Subjects:
(RF) Otorhinolaryngology
Adult
Biological and medical sciences
Epistaxis
Epistaxis - etiology
Epstein-Barr Virus Infections - complications
Female
Hematologic and hematopoietic diseases
Humans
Kidney Transplantation
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Lymphoproliferative Disorder
Lymphoproliferative Disorders - complications
Lymphoproliferative Disorders - diagnosis
Medical sciences
Nasal Cavity
Non tumoral diseases
Otorhinolaryngology. Stomatology
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
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Summary:An unusual case of epistaxis resulting from post-transplant lymphoproliferative disorder is described. A 30-year-old woman who had undergone renal transplantation 12 years previously presented with profuse, posterior, unilateral epistaxis. The initial findings, workup and treatment are presented. A post-nasal space (PNS) mass was detected and biopsy showed this to be an Epstein-Barrvirus-positive polymorphous B-cell post-transplant lymphoproliferative disorder. Computed tomography findings showed a polypoid lesion protruding from the sphenoethmoidal recess and filling the left PNS. Post-transplant lymphoproliferative disorder is well known to involve tonsil tissue. Commonly, this is the first presentation of the disease in children. However, until now post-transplant lymphoproliferative disorder has not been described in the PNS or nasal cavity presenting as epistaxis. We conclude that all transplant patients presenting with epistaxis should be followed up for an accurate examination of the PNS and nasal cavity after the acute episode.
ISSN:0022-2151
1748-5460
DOI:10.1258/0022215042703787