A poorly differentiated lymphoma of donor origin in a renal allograft recipient.
Malignant lymphoma is a frequent complication of organ transplantation. It has been suggested that such tumors arise as a result of uncontrolled proliferation of Epstein-Barr virus-infected B lymphocytes in an immunosuppressed host. Although a few cases of posttransplant lymphomas in bone marrow transplantation have been shown to be of donor cell origin, no recipients of solid-organ transplants are known to have developed lymphomas arising from donor cells. In this report, a case of diffuse high-grade lymphoma that apparently arose in the allograft of a renal transplant recipient is described. DNA fingerprinting demonstrated the tumor to be of donor origin; Epstein-Barr sequences were absent. A therapeutic trial consisting of withdrawal of immunosuppressive agents and administration of acyclovir was unsuccessful. These data support the notion that donor cells can undergo malignant transformation in solid-organ transplant recipients, and such tumors need not carry EBV genetic material.
Hjelle
B
B
Department of Laboratory Medicine, University of California, San Francisco 94143.
Evans-Holm
M
M
Yen
T S
TS
Garovoy
M
M
Guis
M
M
Edman
J C
JC
D000293:Adolescent; D001402:B-Lymphocytes / Q000473:pathology; D002454:Cell Differentiation; D006801:Humans; D007133:Immunoglobulin Joining Region / Q000235:genetics; D016030:Kidney Transplantation; D008223:Lymphoma / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D008297:Male; D009693:Nucleic Acid Hybridization; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000009:adverse effects
D007133:Immunoglobulin Joining Region