Case report
Year : 2025 | Volume : 9 | Issue : 2 | Page : 56-61
Monomorphic Post-Transplant Lymphoproliferative Disorder Presenting as Multiple Small-Bowel Perforations: A Clinicopathological Correlation
Case Report
Minu Cherian Kailath 1*, Michelle Mathias 2, Sajitha Kaliyath 3, Sreelekshmi Suresh Babu4, Sreeshna Nambhanath5
1 *Department of Pathology, Sree Mookambika Institute of Medical Sciences, Kanyakumari.
2-5 Department of Pathology, K.S Hedge Medical Academy, Mangalore
Address for correspondence:
Minu Cherian Kailath , Department of Pathology, Sree Mookambika Institute of Medical Sciences, Kanyakumari.
Email:minucherry18@gmail.com
Abstract
Post-transplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of lymphoid proliferations arising due to prolonged immunosuppression following solid organ transplantation and represent a serious cause of post-transplant morbidity and mortality. The gastrointestinal tract is a frequent extranodal site of involvement, where disease may present with nonspecific symptoms or rapidly progress to life-threatening complications. We report a rare and fatal case of monomorphic PTLD involving the small intestine in a renal transplant recipient. A 35-year-old male with chronic graft rejection presented with long-standing abdominal pain and subsequently developed acute clinical deterioration requiring emergency surgery. Multiple perforations involving the jejunum and terminal ileum were identified and resected. Histopathological examination revealed diffuse transmural infiltration by atypical lymphoid cells with high-grade cytologic features and extensive necrosis, consistent with monomorphic PTLD of diffuse large B-cell lymphoma type. Epstein–Barr virus testing could not be performed due to rapid clinical decline. Despite surgical intervention and intensive supportive care, the patient developed septic shock and died. This case highlights the aggressive nature of gastrointestinal monomorphic PTLD and emphasizes the need for early clinical suspicion, timely diagnosis, and multidisciplinary management in transplant recipients with unexplained gastrointestinal symptoms.
Acknowledgment
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Conflict of interest
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Source of funding
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How to cite this article: Minu Cherian Kailath , Michelle Mathias, Sajitha Kaliyath , Sreelekshmi Suresh Babu, Sreeshna Nambhanath. Lymphoglandular bodies as useful morphological clue in diagnosis of Lymphoid malignancies- A Case Report, Int J Clinicopathol Correl. 2024; 8(1):12-16. 10.56501/intjclinicopatholcorrel.v9i2.1269.
