Post-transplantation lymphoproliferative disorder of the NK-cell type: a case report and review of the literature.
Post-transplantation lymphoproliferative disorders (PTLDs) are primarily B-cell disorders that are thought to be Epstein-Barr virus (EBV) driven and that can occur months to years after solid organ or bone marrow transplantation. A small percentage of cases have also been shown to be T-cell phenotype, but a PTLD of NK-cell type has not been previously described. We report here the case of a renal transplant recipient in whom a clinically aggressive, histologically monomorphic PTLD developed that was documented to be of an NK-cell phenotype according to paraffin section and flow cytometric immunophenotyping. Molecular-genetic analysis showed the PTLD to contain germline immunoglobulin heavy, kappa light chain, and T-cell receptor beta and gamma genes. Studies for EBV failed to demonstrate the presence of viral infection in tumor cells. Clinical follow-up showed a rapidly fatal course. To our knowledge, this is the first reported case of an EBV-negative PTLD of true NK-cell type.
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Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA.
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Alkan
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D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D017809:Fatal Outcome; D006801:Humans; D016130:Immunophenotyping; D016030:Kidney Transplantation; D007694:Killer Cells, Natural / Q000276:immunology / Q000473:pathology*; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000276:immunology / Q000473:pathology*; D008297:Male; D011183:Postoperative Complications
D015703:Antigens, CD