What is the clinical presentation of PTLD?
PTLD can be divided into “early” and “late.” Early PTLD is seen in younger patients who have a de nova EBV infection. The kidney allograft is involved in 57% of cases. This is responsive to immunosuppression reduction. Late PTLD occurs after the first year and is usually more disseminated and does not respond as well to immunosuppression reduction. Most patients present with nonspecific complaints, including fatigue, weight loss, and fever. Some patients present with symptoms resembling infectious mononucleosis. Up to 10% to 15% of PTLD present with central nervous system involvement. A patient may present with lymphadenopathy or palpable masses. Extranodal involvement is common. Given the nonspecific nature of clinical presentation, the diagnosis of PTLD requires a high index of suspicion.
