title: Posttransplantation cutaneous B-cell lymphoma with monoclonal Epstein-Barr virus infection, responding to acyclovir and reduction in immunosuppression.
abstract: Posttransplantation lymphoproliferative disorders (PTLDs) represent an important complication of solid organ transplantation. The main causative factor of PTLDs seems to be the intensity and type of immunosuppressive therapy and the frequent occurrence of Epstein-Barr virus infection. PTLDs that are disseminated at diagnosis or present late after transplantation generally share an unfavorable prognosis and are unlikely to regress in response to reduction in immunosuppressive therapy. We describe a case of cutaneous B-cell lymphoma occurring 4 years after heart transplantation in which molecular analysis revealed a monoclonal pattern of Epstein-Barr virus infection and immunoglobulin gene rearrangement. In spite of its monoclonal nature and late occurrence, the lymphomatous lesions regressed completely after antiviral treatment and a reduction in immunosuppressive therapy.
authors.affiliation: Istituto di Dermatologia, Università di Milano, Ospedale Maggiore IRCCS, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Mozzanica
authors.forename: A
authors.initials: A
authors.lastname: Cattaneo
authors.forename: N
authors.initials: N
authors.lastname: Fracchiolla
authors.forename: V
authors.initials: V
authors.lastname: Boneschi
authors.forename: E
authors.initials: E
authors.lastname: Berti
authors.forename: E
authors.initials: E
authors.lastname: Gronda
authors.forename: M
authors.initials: M
authors.lastname: Mangiavacchi
authors.forename: A F
authors.initials: AF
authors.lastname: Finzi
authors.forename: A
authors.initials: A
authors.lastname: Neri
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage* / Q000009:adverse effects; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D016027:Heart Transplantation / Q000276:immunology*; D006566:Herpesviridae Infections / Q000188:drug therapy* / Q000276:immunology; D004854:Herpesvirus 4, Human; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000188:drug therapy* / Q000276:immunology; D011183:Postoperative Complications / Q000188:drug therapy* / Q000276:immunology; D011379:Prognosis; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000276:immunology; D014412:Tumor Virus Infections / Q000188:drug therapy* / Q000276:immunology
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D000212:Acyclovir