A Violaceous Nodule in a Lung-transplant Patient

• Published in: Dermatology online journal Vol. 22; no. 6
• Main Authors: Milford, Emily, Winslow, Caroline, Danhof, Rebecca
• Format: Journal Article
• Language: English
• Published: United States 15.06.2016
• Subjects: Antineoplastic Agents - therapeutic use; Female; Graft Rejection - prevention & control; Humans; Immunocompromised Host; Immunosuppressive Agents - adverse effects; Leg; Lung Transplantation; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - etiology; Lymphoma, Large B-Cell, Diffuse - immunology; Lymphoma, Large B-Cell, Diffuse - pathology; Middle Aged; Neoplasm Recurrence, Local - etiology; Neoplasm Recurrence, Local - immunology; Neoplasm Recurrence, Local - pathology; Pulmonary Disease, Chronic Obstructive - surgery; Rituximab - therapeutic use; Skin Neoplasms - drug therapy; Skin Neoplasms - etiology; Skin Neoplasms - immunology; Skin Neoplasms - pathology
• ISSN: 1087-2108; 1087-2108
• DOI: 10.5070/D3226031328

Posttransplantation lymphoproliferative disorder (PTLD) is a rare complication of solid organ or allogenic bone marrow transplantation. Cases localized to the skin are even rarer, with only around 100 cases recorded in the literature [2]. We present a case of 60 year-old-woman, a lung transplant recipient, who presented with an asymptomatic violaceous nodule on her left medial calf. Histopathology was consistent with PTLD of the B-cell subtype, EBV negative. This case is unique in that it was of the B cell subtype of cutaneous PTLD, which has been less commonly observed than the T cell subtype. In addition, the case was EBV negative, which is rare in B cell cutaneous PTLD. The patient was treated with rituximab 600 mg IV weekly for four weeks and cytomegalovirus immune globulin (Cytogam) 100 mg/kg once, with resolution of the nodule.