Necrotic adenoids in post-transplant lymphoproliferative disorders
L. Spinato, P. Brihaye, A. De Ganseman, T. Marquet and A.-L. Mansbach
Department of Otorhinolaryngology Head and Neck Surgery, University Children’s Hospital Queen Fabiola, Free University of Brussels, Belgium
Post-transplant lymphoproliferative disorders; necrotic adenoids, EBV
61 - 64
Necrotic adenoids in post-transplant lymphoproliferative disorders. Problem: Post-transplant lympho- proliferative disorders (PTLD) are a potentially fatal complication after solid organ transplantation.The majority of cases are associated with Epstein Barr virus infection (EBV). The first manifestations of PTLD are frequently observed in the ENT area with adenoidal and/or tonsillar enlargement. Methodology: We present the case of a 12-year old girl with a total nasal obstruction and tonsillitis five months after a kidney transplantation for bilateral congenital kidney hypoplasia. Results: The EBV genome was detected by polymerase reaction three months after surgery. Fiberoptic examination revealed an obstructive necrotic mass in the naso-pharynx. The anatomic-pathologic analysis revealed necrotic adenoids. Conclusions: Necrotic tonsillitis is common. Necrosis of the adenoids, although rarer, can also occur and explains the important respiratory distress. Since two thirds of PTLD patients present with clinical symptoms in the ENT area, the otorhinolaryngologist should be aware of this complication.
Vol. 7, 2011, 1st trimester

Necrotic adenoids in post-transplant lymphoproliferative disorders