Lymphoproliferative disorders in renal transplant patients in Japan.
Post-transplantation lymphoproliferative disorders (PT-LPD) are characterized by a clinically and morphologically heterogeneous group of lymphoid proliferation occurring after organ or bone marrow transplantation. The immunodeficient state provides a basis for lymphomagenesis probably through activation of oncogenic viruses. Twenty-four patients in whom PT-LPD developed after renal transplantation in Japan were analyzed. They received hemodialysis for 4 to 226 (median 13) months before transplantation. In situ hybridization was performed to detect Epstein-Barr virus (EBV). Polymerase chain reaction and Southern hybridization with primers in the tax and pol regions of human T-cell leukemia virus type I (HTLV-1) were performed on DNA extracted from paraffin-embedded specimens. Immunohistochemical analysis revealed that 12 cases were B-cell type, 10 cases (42%) T-cell type and 2 NK-cell type. Five of the T-cell cases were classified as adult T-cell lymphoma with proven HTLV-1 genome in the tumor and seropositivity for the virus. These cases were classified as adult T-cell lymphoma (ALT). More than 80% of B-cell, 30% of T-cell and both NK/T-cell lymphomas were EBV-positive. Co-infection of EBV and HTLV-1 was found in 2 cases with ATL. These findings showed that ATL is common among Japanese renal transplant patients, which might be due to transmission of HTLV-1 via blood transfusion during hemodialysis.
Department of Pathology, Osaka University Medical School, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Y
Y
Hoshida
T
T
Li
Z
Z
Dong
Y
Y
Tomita
A
A
Yamauchi
J
J
Hanai
K
K
Aozasa
D000293:Adolescent; D000328:Adult; D017931:DNA Primers / Q000737:chemistry; D004279:DNA, Viral / Q000032:analysis; D020031:Epstein-Barr Virus Infections / Q000209:etiology* / Q000821:virology; D005260:Female; D015490:HTLV-I Infections / Q000209:etiology* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D015368:Human T-lymphotropic virus 1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007124:Immunoenzyme Techniques; D016130:Immunophenotyping; D017403:In Situ Hybridization; D016030:Kidney Transplantation / Q000009:adverse effects*; D016393:Lymphoma, B-Cell / Q000209:etiology / Q000235:genetics; D016399:Lymphoma, T-Cell / Q000209:etiology / Q000235:genetics; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D006435:Renal Dialysis
D017931:DNA Primers; D004279:DNA, Viral