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Post-transplant lymphoproliferative disorder recurrence in the scapula

Imaging findings

Chest CT and radiographs in a lung transplant recipient show an enormous, expansile, lytic bone lesion involving the right scapula, representing recurrent Epstein-Barr virus positive post-transplant lymphoproliferative disorder four years after a previously resolved pulmonary PTLD nodule.

Key takeaways

Post-transplant lymphoproliferative disorder is a serious complication of immunosuppression, most commonly EBV-associated. While typically presenting in the transplanted lungs, it can rarely recur in bones as a destructive, expansile lytic lesion, mimicking metastatic renal cell carcinoma or primary bone sarcoma.

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