Early development of Epstein-Barr virus-associated T-cell lymphoma after a living-related renal transplantation.
We herein report a case of Epstein-Barr virus (EBV)-associated T-cell lymphoma that developed within a month after a kidney transplantation. The recipient was a 37-year-old man who had evidence of a previous EBV infection. Cyclosporine, methylprednisolone, and azathioprine were used for immunosuppression, and acute rejection was treated with high-dose methylprednisolone. The lactate dehydrogenase level started to increase on day 24 and thereafter peaked on day 37 while also demonstrating progressive jaundice and a bleeding tendency. A transplant nephrectomy was done on day 37; however, the patient could not recover and eventually died of respiratory failure as a result of diffuse pulmonary edema. A pathological examination of the resected kidney revealed a diffuse proliferation of large atypical lymphoid cells in the parenchyma. Immunohistochemically, the tumor cells were positive for CD45 and T-cell marker, CD45RO, but negative for B-cell markers. EBV-encoded RNA was demonstrated within the neoplastic cells by in situ hybridization.
Kidney Center, Saiseikai Yahata Hospital, Kitakyushu, Japan.
C
C
Yasunaga
T
T
Kasai
G
G
Nishihara
K
K
Matsuo
K
K
Takeda
M
M
Urabe
M
M
Nakamoto
T
T
Goya
D000328:Adult; D006566:Herpesviridae Infections / Q000209:etiology*; D004854:Herpesvirus 4, Human; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D017493:Leukocyte Common Antigens / Q000032:analysis; D016399:Lymphoma, T-Cell / Q000209:etiology*; D008297:Male; D014412:Tumor Virus Infections / Q000209:etiology*
D017493:Leukocyte Common Antigens