0:00

This patient has a history of renal transplants and

0:03

had abdominal pain had a finding on a CT scan.

0:06

This was followed by Pepsi tea. And so I wanted to

0:09

Showcase some of the findings on the PET CT on the

0:12

non-contrast portion of the PET CT. We can see that there's

0:15

quite a bit of adenopathy here a large large lymph nodes

0:18

within the mesentery this large

0:21

one over here and then look at this Loop of bowel over

0:24

here. See how thickened it is as well compared to some of these other Loops to

0:27

a bowel wall is essentially a perceptible in this

0:30

small bowel. Look here quite thicken and looks like it has a soft tissue attenuation.

0:34

As we go lower down you can see the right lower quadrant

0:37

renal transplant over here.

0:39

And in the leftover quadrant, you can also see a transplant which

0:42

is quite a trophic. So this is a failed renal transplant within the

0:45

left lower quadrant.

0:48

On the PET CT images on this patient we can see that the adenopathy

0:51

is very ftg of it

0:54

here all these nodes over here. And if we

0:57

just go right to that Loop of bowel over here. Look how fdg Avid

1:00

a loop of bowel is and so this is

1:03

certainly taking up and picking up that radio tracer.

1:06

In the context of somebody who has a real transplant the

1:09

overall findings have to be concerning or

1:12

at least one thing it has to be brought up is post-transplant lymphoproliferative

1:15

disorder and seeing a

1:18

case of post transplant. Liverpool is sort of within the kidney itself

1:21

and certainly can be within the kidney or immediately surrounding

1:24

the kidney that it's important to remember that it

1:27

may also be location sort of distant from

1:30

the kidney as in this instance in the bowel as well as within the

1:33

mesentery we see nodes and so you can see

1:36

it as nodes distant from the renal transplant. It

1:39

can be external and it's distribution with involvement

1:42

of the small bowel involving the liver other organs.

1:45

And so this case nicely showcases nodal and

1:49

extra nodal distribution of ptld a

1:52

diagnosis. That was then made via a biopsy

1:55

in this instance.