Clinical and radiologic features of malignant neoplasms in organ transplant recipients: cyclosporine-treated vs untreated patients

The radiologic and clinical features of 37 posttransplantation malignant tumors occurring in 33 organ transplant recipients were reviewed to determine the characteristics of the tumors, particularly in relation to previous treatment (or nontreatment) with cyclosporine. The 37 malignant tumors included lymphomas (eight in patients receiving cyclosporine and four in patients not given cyclosporine) and carcinomas of the skin and lips (11), head and neck (five), colon and rectum (three), uterus (two), vulva (two), lung (one), and urinary bladder (one). The neoplasms of the internal viscera and head and neck were relatively advanced when detected. The neoplasms of the skin, vulva, uterine cervix, and urinary bladder were low-grade malignant tumors. Most of the cyclosporine-induced malignant lesions were lymphomas. The lymphomas in cyclosporine-treated recipients were characterized by early appearance after transplantation; more extensive organ involvement; multiple, homogeneous solid lesions without central low density on CT and sonography; and regression after reduction of cyclosporine dose. We conclude that malignant tumors occurring after transplantation are often advanced and that lymphoma induced by cyclosporine has characteristic features.