Multifocal Hepatic Epstein-Barr Virus-Associated Smooth Muscle Tumor Mimicking Posttransplant Lymphoproliferative Disorder in a Renal Allograft Recipient.
Prashanth Srinivasan, Srinivas Ananth Kumar, Harish Goyal et al.
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Case in brief
A 19-year-old renal transplant recipient presented with abdominal symptoms suggestive of posttransplant lymphoproliferative disorder (PTLD). Imaging with 18F-FDG PET/CT revealed multiple hypermetabolic liver lesions. Histopathological examination confirmed the diagnosis of Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT). Following treatment with mTOR inhibition, a follow-up PET/CT showed a partial metabolic response.
Diagnostic / clinical pearl
Clinicians should consider Epstein-Barr virus-associated smooth muscle tumors in immunocompromised patients presenting with abdominal symptoms and hypermetabolic liver lesions, as they can mimic posttransplant lymphoproliferative disorder.
Why it matters
This case underscores the utility of 18F-FDG PET/CT in differentiating between EBV-SMT and PTLD, which is crucial for appropriate management in transplant recipients.