A Rare Finding at the Hepaticojejunostomy in a Postliver Transplant Patient

A 30-year-old man with a history of liver transplantation (LT) for primary sclerosing cholangitis presented with a clinical picture compatible with ascending cholangitis. The patient was started on antibiotic therapy, and a magnetic resonance imaging with cholangiopancreatography (MRCP) revealed biliary dilation. The patient then underwent double-balloon endoscopic retrograde cholangiopancreatography (DBE-ERCP). Endoscopic findings revealed an ulcerated mass obstructing the hepatico-jejunostomy (HJ), and biopsies were taken. Pathology was compatible with nondestructive post-transplant lymphoproliferative disorder, and the patient received treatment with rituximab. Eight weeks after treatment, repeat DBE-ERCP showed resolution of the mass and a patent HJ. To our knowledge, this is the first report of a diagnosis of post-transplant lymphoproliferative disorder at the HJ after LT identified with DBE-ERCP.