title: Intragraft angiotropic large-cell lymphoma of T cell-type in a long-term renal allograft recipient.
abstract: Chronic immune suppression is a risk for the development of post-transplantation lymphoproliferative disorders, which are frequently caused by a B-cell dyscrasia. We report a unique primary presentation of the rare angiotropic lymphoma in a kidney allograft, 18 years after transplantation. The diagnosis was made by a percutaneous allograft biopsy specimen when the recipient presented with renal dysfunction and intermittent hematuria. Immunostaining of the biopsy specimen revealed a T-cell lineage of the neoplastic cells rather than the more common B-cell source. At the time of biopsy, there was no evidence of systemic dissemination of lymphoma. The intragraft lymphoma resolved completely after chemotherapy, but the patient died 6 months later as a result of an intracerebral hemorrhage. At autopsy, intravascular lymphoma was only found in the cerebral vessels. To the authors' knowledge, this is the first report of angiotropic T-cell lymphoma in a kidney allograft. A description of the clinical, pathologic, and immunohistochemical features of this case is provided, as well as reviews of previous reports of renal angiotropic lymphoma and post-transplantation T-cell lymphomas.
authors.affiliation: University of Tennessee-Memphis, Department of Pathology 38163, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: Ghorbani
authors.forename: H
authors.initials: H
authors.lastname: Shokouh-Amiri
authors.forename: L W
authors.initials: LW
authors.lastname: Gaber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000943:Antigens, Differentiation / Q000032:analysis; D001344:Autopsy; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007165:Immunosuppression Therapy; D007680:Kidney Neoplasms / Q000150:complications / Q000473:pathology*; D016030:Kidney Transplantation; D017493:Leukocyte Common Antigens / Q000032:analysis; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000473:pathology*; D016399:Lymphoma, T-Cell / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D000943:Antigens, Differentiation; D017493:Leukocyte Common Antigens