Introduction: Inflammatory myofibroblastic tumor (IMT) is a rare benign tumor, accounting for 0.7% of all lung tumors. The tumor occurs most commonly in children and young adults and its aetiology is still not completely understood. We report a case who had a liver transplantation four years ago and presented with post-transplant lymphoproliferative disease and inflammatory myofibroblastic tumor involving lung.

Case Report: Six months old boy was referred to the Transplant Department at Başkent University, with biliary atresia presented with jaundince to thrive since he was born. In our institution, he received a left lateral segment liver transplant at the age of 9 months from his mother who was 23 years old and started to use tacrolimus based immunosuppression regimen. Eleven months later, when he presented with longstanding diarrhea, upper gastrointestinal system endoscopy and colonoscopy was performed, and ulcerations with malign appearance were seen both in his antrum and colon. Endoscopic biopsies were taken and the histological diagnosis was posttransplant lymphoproliferative disease (PTLD). Expression of EBV-encoded RNA (EBER) was found as positive in these biopsies. He had started to receive chemotherapy, including cyclophosphamide for the treatment of PTLD. Because of having fewer and cough at the time of second chemoterapy, computed tomograpy of the chest was performed and it revealed a solid lung mass in the left inferior lobe. The transthorasic biopsy was performed and the histological diagnosis was reported as inflammatory myofibroblastic tumor of the lung. The child has remained well during 3 years of follow-up with no evidence of recurrence both of PTLD and inflammatory myofibroblastic tumor.

Conclusions: IMTs of the lung are extremely rare and their aetiology is currently unknown. It has been hypothesized that an initial infection may lead to an IMT, such as mycoplasma, nocardia, actinomycetes, Epstein-Barr and human herpes virus. In our case the presence of synchronous IMT and PTLD may explain the possible cause, because both of the tumor may appear as a cause of EBV infection, as mentioned in some of reports in the literature.