title: Epstein-Barr virus-associated hepatic smooth muscle neoplasm in a cardiac transplant recipient.
abstract: Host immunosuppression is increasingly recognized as a significant risk factor for the development of a primary neoplasm. Chronic immunosuppressive therapy, as used in organ transplantation, may perturb the immunosurveillance ability of the host, making the patient more susceptible to virus-associated malignancies. We have taken care of a care of a child who received an orthotopic heart transplant and who then developed both a generalized lymphoproliferative disorder and a leiomyoma of the liver a year later. Epstein-Barr virus DNA was detected in a lymph node initially and the hepatic tumor cells subsequently. The former responded to a reduction in the immunosuppressive medications and the latter responded to surgical resection. This is the first report of a hepatic smooth cell neoplasm occurring following cardiac transplant and the development of two sequential Epstein-Barr virus-associated disorders in an immunosuppressed patient.
authors.affiliation: Department of Surgery, Children's Hospital of Philadelphia, Pennsylvania, 19104-4399, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Davidoff
authors.forename: A
authors.initials: A
authors.lastname: Hebra
authors.forename: B J
authors.initials: BJ
authors.lastname: Clark
authors.forename: J E
authors.initials: JE
authors.lastname: Tomaszewski
authors.forename: K T
authors.initials: KT
authors.lastname: Montone
authors.forename: E
authors.initials: E
authors.lastname: Ruchelli
authors.forename: H T
authors.initials: HT
authors.lastname: Lau
mesh_terms: D002648:Child; D016027:Heart Transplantation / Q000009:adverse effects*; D006566:Herpesviridae Infections / Q000209:etiology; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D017403:In Situ Hybridization; D007889:Leiomyoma / Q000209:etiology* / Q000473:pathology; D008113:Liver Neoplasms / Q000209:etiology* / Q000473:pathology; D008232:Lymphoproliferative Disorders / Q000209:etiology; D008297:Male; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D014412:Tumor Virus Infections / Q000209:etiology
chemical_list: D007166:Immunosuppressive Agents; D012367:RNA, Viral