Primary peripheral T cell lymphoma in a kidney transplant under immunosuppression with cyclosporine A.
A 56-year-old patient received a cadaveric renal allograft because of primary cystic kidney disease. The donor was a 28-year-old man who died from head trauma. No other major illnesses were present at the time of transplantation. Immunosuppression was performed with cyclosporine A and steroids. After 3 months, the patient presented with fever and abdominal pain which was located in the region of the allograft. Ultrasonography demonstrated a tumor mass at the renal transplant hilus that was suspected to be an infected hematoma. Kidney biopsy from the cortex revealed only severe morphologic signs of cyclosporine A toxicity which was due to high cyclosporine A levels during the first 2 months after transplantation. The patient died from pulmonary embolism 6 months posttransplant. Histologic evaluation of the tumor specimens obtained at autopsy showed an extensive infiltration of the renal hilus and the medulla by a peripheral T cell lymphoma of the large-cell type. The T cell origin was confirmed by immunohistochemistry using the T cell-associated monoclonal antibodies UCHL-1 and MT1.
Ulrich
W
W
Department of Pathology, University of Vienna, Austria.
Chott
A
A
Watschinger
B
B
Reiter
C
C
Kovarik
J
J
Radaszkiewicz
T
T
D000328:Adult; D000943:Antigens, Differentiation / Q000378:metabolism; D003524:Cyclosporins / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006649:Histocompatibility Antigens / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects / Q000473:pathology*; D017493:Leukocyte Common Antigens; D008223:Lymphoma / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes
D000943:Antigens, Differentiation; D003524:Cyclosporins; D006649:Histocompatibility Antigens; D017493:Leukocyte Common Antigens