{
  "abstract": "Background and Aims Lower extremity radiculopathy and edema are common presentations in elderly patients, often attributed to spinal or vascular pathologies. However, in immunocompromised individuals such as kidney transplant recipients, malignancy must also be considered. This case report highlights the importance of a broad differential diagnosis, particularly in long-term post-transplant patients with atypical symptoms.Methods A 77-year-old woman, 15 years post-kidney transplantation and under long-term immunosuppression, presented with left thigh numbness and lower extremity edema. Lumbar spine MRI initially suggested foraminal stenosis and herniation. Conservative management yielded limited improvement. As symptoms progressed, including persistent edema and right lower limb swelling, further imaging was performed.Results Contrast-enhanced CT revealed a 9.9 × 6.4 cm retroperitoneal mass compressing the right iliac vessels. Biopsy confirmed diffuse large B-cell lymphoma (DLBCL), germinal center subtype, arising in a post-transplant immune-deficient setting. PET-CT staging identified multiple FDG-avid lymph nodes consistent with stage III disease. The patient underwent R-CHOP chemotherapy, with subsequent improvement in symptoms and reduction in tumor size. Immunosuppressive therapy was adjusted accordingly. She remains under oncologic follow-up with stable status.Abstract P028 Figure 1Lumbar spine MRI showing lumbar 5-sacrum 1 foraminal stenosis and disc extrusion. (A) Sagittal view; (B) Axial viewAbstract P028 Figure 2Contrast-enhanced CT scan revealing retroperitoneal mass compressing the iliac vessels. (A) Coronal view; (B) Axial viewConclusions This case underscores the importance of considering malignancy in the differential diagnosis of lower extremity symptoms in immunosuppressed post-transplant patients. Initial findings may mimic benign spine disorders, potentially delaying the correct diagnosis. Early, comprehensive evaluation is essential in such populations to improve outcomes.",
  "authors": [
    {
      "affiliations": [
        "Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, St. Vincent’s Hospital, Suwon, Republic of Korea"
      ],
      "name": "Jaesuk Kim"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, St. Vincent’s Hospital, Suwon, Republic of Korea"
      ],
      "name": "So Young Kwon"
    }
  ],
  "title": "P028 Non-hodgkin’s lymphoma presenting with lower extremity symptoms in a post-kidney transplant patient",
  "uid": "949702c8-040b-5983-9b95-875e6f5c6768"
}