Post-Transplantation B-Cell Lymphoproliferative Disorder in a Dual Organ Recipient: A Rare Case Report and Literature Review

Post-transplant lymphoproliferative disorders (PTLD) pose significant risks following organ transplantation, characterized by potential aggressiveness. This report aims to discuss a case of PTLD presenting as B-cell large cell lymphoma (DLBCL) post-kidney and pancreas transplantation. A 44-year-old female with type 1 diabetes underwent kidney and pancreas transplantation. She presented with fever, night sweats, and weakness, revealing multiple lesions on CT, including in transplanted and native kidneys, pancreas and lung. Biopsy of transplant kidney confirmed PTLD, DLBCL subtype, with complex immunohistochemical findings. Chemotherapy (R-CHOP) was initiated but complicated by infusion reactions and bowel perforation necessitating surgery and antibiotics. Despite the complications, the normal function of the transplanted kidney is maintained, which made it possible to implement the standard chemotherapy protocol. This case underscores the diagnostic challenges and therapeutic complexities of PTLD, specifically DLBCL, in transplant recipients. Comprehensive evaluation and vigilant management are crucial for successful outcomes in such cases.