Epstein-Barr virus-associated lymphoproliferative disease in a heart-lung allograft. Demonstration of host origin by restriction fragment-length polymorphism analysis.
An unusual posttransplant lymphoproliferative disorder is reported occurring within 6 weeks of a heart-lung transplantation, in a patient with primary exposure to the Epstein-Barr virus. The tumor presented primarily in the lung allograft as a rapidly fatal bronchopneumonia refractory to antimicrobial therapy. The viral genome was detected within the lesion by Southern blot analysis, and a primary infection was confirmed by serologic studies. Restriction fragment length polymorphism analysis using the LAM 4-1214 probe demonstrated that the tumor infiltrate in the allograft lung was derived not from the donor's bronchial-associated lymphoid tissue but from recipient lymphocytes trafficking through the allograft.
Randhawa
P S
PS
Department of Pathology, Presbyterian University Hospital, University of Pittsburgh School of Medicine, Pennsylvania 15213.
Yousem
S A
SA
D000293:Adolescent; D004247:DNA / Q000032:analysis; D016041:Heart-Lung Transplantation / Q000009:adverse effects*; D006566:Herpesviridae Infections / Q000209:etiology*; D004854:Herpesvirus 4, Human / Q000235:genetics; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D008168:Lung / Q000473:pathology; D008232:Lymphoproliferative Disorders / Q000209:etiology*; D008297:Male; D012150:Polymorphism, Restriction Fragment Length; D011183:Postoperative Complications / Q000209:etiology*
D007075:Immunoglobulin M; D004247:DNA