Ratuapli et al. Journal of Medical Case Reports 2011, 5:5 http://www.jmedicalcasereports.com/content/5/1/5 Page 7 of 8 Figure 7 EGD showing multiple large gastric nodules with central ulceration. Conclusion In summary we report the case of a patient with post-renal transplant large T-cell lymphoma, with an unusual presen- tation of acute appendicitis and EBV positivity. We report successful treatment with chemotherapy and stress the need for heightened awareness of this malignancy in patients with prolonged immunosuppression. Monoclonal T-cell PTLD remains a high mortality disease, and further large multi-centre studies are required to understand the pathogenesis and develop better treatment regimens. Consent Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Table 1 The World Health Organization classification of PTLD Early Lesions Polymorphic PTLD Reactive Plasmacytic Hyperplasia Polyclonal Monoclonal B-Cell Lymphomas Diffuse large B cell lymphoma Burkitt/Burkitt-like lymphoma Plasma cell myeloma Monomorphic PTLD T-Cell Lymphomas Peripheral T cell lymphoma Large CellAnaplastic Unspecified Raretypes (gammadelta, Hepatosplenic, T/NKcell) Other Types 1. Hodgkin’s disease- like 2. Plasmacytoma-like