Necrotic lymphoma in a patient with post-transplantation lymphoproliferative disorder: ultrasonography and CT findings with pathologic correlation

• Main Authors: Minsu Lee, Sang Kyum Kim, Yong Eun Chung, Jin-Young Choi, Mi-Suk Park, Joon Seok Lim, Myeong-Jin Kim, Honsoul Kim
• Format: Article
• Language: English
• Published: Korean Society of Ultrasound in Medicine 2015-04-01
• Series: Ultrasonography
• Subjects: Lymphoma; Ultrasonography; Immunocompromised host
• Online Access: http://www.e-ultrasonography.org/upload/usg-14050.pdf

Seventeen months after kidney transplantation for the treatment of nephrotic syndrome, a retroperitoneal mass was incidentally detected in a 30-year-old man during routine follow-up. Ultrasonography revealed a mass measuring 5.5 cm×4.3 cm located between the liver and the atrophic right kidney, which showed markedly heterogeneous internal echogenicity. Contrast-enhanced computed tomography displayed a mild degree of enhancement only at the periphery of the mass, while the center lacked perceivable intensification. The patient underwent surgical resection. The final pathological diagnosis was non-Hodgkin lymphoma (diffuse large B-cell lymphoma), and extensive necrosis was observed on microscopic examination. We found that the prominent heterogeneous echogenicity of the mass (an unusual finding of lymphoma) demonstrated on ultrasonography is a result of extensive necrosis, which may sometimes occur in patients with post-transplantation lymphoproliferative disorder.