Extradural Thoracic Spinal Cord Compression: Unusual Initial Presentation of Post-transplant Lymphoproliferative Disorder

• Published in: The Journal of heart and lung transplantation Vol. 27; no. 10; pp. 1165 - 1168
• Main Authors: Bakker, Nicholas A., van Dijk, J. Marc C., Slart, Riemer H.J.A., Coppes, Maarten H., van Imhoff, Gustaaf W., Verschuuren, Eric A.M.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2008; Elsevier Science
• Subjects: Adult; alpha 1-Antitrypsin Deficiency - complications; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Cardiology. Vascular system; Cerebrospinal fluid. Meninges. Spinal cord; Cyclophosphamide - administration & dosage; Doxorubicin - administration & dosage; Emphysema - etiology; Emphysema - surgery; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lung Transplantation - adverse effects; Lymphoproliferative Disorders - diagnosis; Magnetic Resonance Imaging; Male; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Postoperative Complications - diagnosis; Prednisone - administration & dosage; Radionuclide Imaging; Spinal Cord - pathology; Spinal Cord Compression - diagnosis; Spinal Cord Compression - etiology; Spinal Cord Compression - pathology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Thoracic Neoplasms - diagnostic imaging; Thoracic Neoplasms - drug therapy; Treatment Outcome; Vincristine - administration & dosage; Nervous system diseases; Hemopathy; Phlebology; Extradural; Posttransplant lymphoproliferative disorder; Lymphoproliferative syndrome; Central nervous system disease; Spinal cord compression; Circulatory system; Cardiology; Spinal cord disease; Inaugural sign; Thoracic spinal cord
• ISSN: 1053-2498; 1557-3117; 1557-3117
• DOI: 10.1016/j.healun.2008.06.008

Post-transplant lymphoproliferative disorder (PTLD) is a serious complication after solid-organ transplantation. We report a lung transplant recipient presenting with lower limb weakness as a result of extradural cord compression from PTLD. Diagnosis was made by laminectomy of T-3 with partial removal of the epidural mass. Further treatment consisted of chemoradiotherapy. The patient recovered completely. To our knowledge, this is the first reported case of PTLD presenting with signs and symptoms of spinal cord compression. The differential diagnosis of spinal cord compression in a patient who has had a transplant should include primary presentation of PTLD.