Post-transplantation lymphoproliferative disorder of the T-cell/B-cell type: an unusual manifestation in a renal allograft.
Marked impairment of the cellular immune system predisposes renal transplant recipients to Epstein-Barr virus (EBV) associated clinical syndromes. This can culminate in post-transplantation lymphoproliferative disorders (PTLD) and malignant lymphomas. An unusual PTLD in a 59-year-old renal transplant recipient is reported here. Sonography and CT scan revealed a hypovascular infiltrating tumor mass in the lower pole of the graft which on histopathologic examination revealed a monotonous lymphoid proliferation. T-cell receptor and immunoglobulin heavy chain gene rearrangement as well as immunohistochemical analyses demonstrated a polyclonal origin of atypical lymphatic T- and B-cells. The Epstein-Barr viral genome was detected in the mass by Southern blot analysis, and a primary EBV infection was confirmed by serologic studies. Clinical follow-up showed a tumor-free course till the patient's sudden cardiac death 14 months after the operation.
Wirnsberger
G H
GH
Department of Internal Medicine, Division of Nephrology, Karl-Franzens University, A-8036 Graz, Austria.
Ratschek
M
M
Dimai
H P
HP
Holzer
H
H
Mandal
A K
AK
D000328:Adult; D001402:B-Lymphocytes / Q000473:pathology; D016358:Contact Tracing; D003586:Cytomegalovirus Infections / Q000150:complications; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000635:transmission*; D006084:Graft Rejection / Q000188:drug therapy; D006561:Herpes Simplex / Q000150:complications; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007680:Kidney Neoplasms / Q000209:etiology* / Q000601:surgery / Q000821:virology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008228:Lymphoma, Non-Hodgkin / Q000209:etiology* / Q000601:surgery / Q000821:virology; D008297:Male; D008875:Middle Aged; D014411:Neoplastic Stem Cells / Q000473:pathology; D009392:Nephrectomy; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology*; D011704:Pyelonephritis / Q000601:surgery; D013601:T-Lymphocytes / Q000473:pathology; D014019:Tissue Donors