Otolaryngological manifestations of posttransplant lymphoproliferative disorder in pediatric thoracic transplant patients Brian W. Herrmann a, * , Stuart C. Sweet b , Robert J. Hayashi b , Charles E. Canter b , Frances V. White c , Judith E.C. Lieu a a Washington University School of Medicine, Department of Otolaryngology–—Head and Neck Surgery, St. Louis, MO, USA b Washington University School of Medicine, Department of Pediatrics, St. Louis, MO, USA c Washington University School of Medicine, Department of Pathology and Immunology, St. Louis, Mo, USA Received 21 March 2005; accepted 9 July 2005 International Journal of Pediatric Otorhinolaryngology (2006) 70, 303—310 www.elsevier.com/locate/ijporl KEYWORDS Posttransplant; Lymphoproliferative; PTLD; Heart; Lung; Otolaryngology; Pediatric Summary Objective: To identify the otolaryngological manifestations of posttransplant lym- phoproliferative disorder (PTLD) in pediatric heart and lung transplant recipients. Methods: A 14-year retrospective case series review (1990—2003) of children less than 18 years of age presenting with PTLD after receiving orthotopic heart and lung transplants at St. Louis Children’s hospital (St. Louis, MO, USA). Results: One hundred ninety seven cardiac and 246 pulmonary transplant patients were included in this review. Thirteen heart transplant patients developed PTLD with 39% (5/13) presenting in the head and neck. Thirty-two lung transplant patients developed PTLD with 25% (8/32) presenting in the head and neck. PTLD in cardiac transplants most often presented as adenotonsillar hypertrophy or cervical lympha- denopathy. The sinonasal cavity was the most common site of head and neck PTLD in pulmonary transplants patients. Conclusions: This study suggests that head and neck involvement is more common than currently reported in the literature. As thoracic organ transplants become more frequent in children, otolaryngologists caring for this population should maintain a high index of suspicion for any suggestive findings. Evaluation must include tissue biopsy, as histopathologic examination is required for diagnosis. # 2005 Elsevier Ireland Ltd. All rights reserved. * Corresponding author. Present address: Pediatric Ear, Nose, & Throat of Atlanta, 5455 Meridian Mark Rd., Suite 130, Atlanta, GA 30342, USA. Tel.: +1 404 255 2033; fax: +1 404 252 1901. E-mail address: bherrmann@childrensent.com (B.W. Herrmann). 0165-5876/$ — see front matter # 2005 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijporl.2005.07.011