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Arch Otolaryngol Head Neck Surg. 2000 Dec;126(12):1444-7.

The effectiveness of tonsillectomy in diagnosing lymphoproliferative disease in pediatric patients after liver transplantation.

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  • 1Department of Otolaryngology-Head and Neck Surgery, University of Texas at Southwestern, 5323 Harry Hines Blvd, Dallas, TX 75235, USA.

Abstract

OBJECTIVE:

To determine the effectiveness of diagnosing forms of lymphoproliferative disease by performing tonsillectomy in pediatric patients who develop symptomatic or asymptomatic tonsillar hypertrophy during immunosuppressive therapy after liver transplantation.

DESIGN:

Retrospective chart and pathological review.

SETTING:

Urban tertiary referral children's hospital.

MAIN OUTCOME MEASURES:

The presence of a pathological stage of lymphoproliferative disease or Epstein-Barr virus (EBV) diagnosed using tonsillar specimens, resulting in a change in therapy.

RESULTS:

Of 275 pediatric patients who underwent liver transplantation, 13 had tonsillectomy performed with histopathological review of the tonsillar specimens. The specimens from 5 patients (39%) demonstrated pathological changes thought to be consistent with EBV-related changes or a form of lymphoproliferative disease. Histological changes ranged from tonsillar hyperplasia associated with EBV infection to large cell lymphoma. Immunosuppressive therapy was reduced or discontinued, and antiviral therapy was initiated.

CONCLUSION:

Children who have undergone liver transplantation and develop tonsillar hypertrophy should undergo a diagnostic tonsillectomy, regardless of the clinical presentation, to rule out a form of posttransplant lymphoproliferative disease. Arch Otolaryngol Head Neck Surg. 2000;126:1444-1447

PMID:
11115279
[PubMed - indexed for MEDLINE]
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