CTICasesPost-Transplant Lymphoproliferative Disorder (PTLD) Mimicking Peritoneal Carcinomatosis
Imaging findings
A kidney transplant recipient with systemic symptoms had bilateral pleural effusions, one of which appeared loculated/exudative with associated lung entrapment, along with pericardiophrenic lymph node enlargement, pericardial fluid, and omental caking in the upper abdomen resembling metastatic abdominal malignancy (such as colon, appendiceal, or ovarian cancer); further review identified tumor deposits in the right paracolic gutter, and the process proved to be PTLD manifesting as a T-cell lymphoma diffusely mimicking peritoneal carcinomatosis.
Key takeaways
In a solid-organ transplant recipient, a diffuse pattern of pleural, pericardial, and peritoneal/omental disease that mimics metastatic carcinomatosis should prompt consideration of post-transplant lymphoproliferative disorder before assuming a new primary malignancy, since PTLD can present with this atypical, multi-compartment serosal distribution rather than a discrete mass.
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