Post-transplant malignant lymphoma with monoclonal immunoglobulin gene rearrangement and polyclonal Epstein-Barr virus episomes.
This report describes the case of an 8 year old boy who developed ileocecal B cell lymphoma after liver transplantation. The patient underwent orthotopic liver transplantation for biliary atresia and had been given immunosuppressive drugs--cyclosporin A and tacrolimus hydrate. Six years after the liver transplantation, the patient had a sudden onset of fever and abdominal pain. Necropsy revealed an ileocecal mass that was a B cell lymphoma. Epstein-Barr virus (EBV) encoded RNA 1 was demonstrated in lymphoma cells and hyperplastic follicular germinal centre cells in various tissues. Although monoclonal immunoglobulin gene rearrangement was detected in the liver, EBV episomes were of polyclonal origin and lytic forms of EBV were also demonstrated by Southern blotting. Immunohistochemically, lymphoma cells were positive for p53 but negative for latent membrane protein 1 and EBV nuclear antigen 2. These findings suggested that this B cell lymphoma might have occurred sporadically, regardless of EBV infection.
Sadahira
Y
Y
Department of Pathology, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Kurashiki, Japan. sadapath@med.kawasaki-m.ac.jp
Kumori
K
K
Mikami
Y
Y
Otsuki
T
T
Manabe
T
T
Aoyama
K
K
D001656:Biliary Atresia / Q000235:genetics / Q000473:pathology / Q000601:surgery; D002430:Cecal Neoplasms / Q000235:genetics / Q000473:pathology*; D002648:Child; D017809:Fatal Outcome; D015322:Gene Rearrangement, B-Lymphocyte; D005803:Genes, Immunoglobulin; D004854:Herpesvirus 4, Human / Q000235:genetics; D006801:Humans; D007078:Ileal Neoplasms / Q000235:genetics / Q000473:pathology*; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000235:genetics / Q000473:pathology*; D016031:Liver Transplantation; D016393:Lymphoma, B-Cell / Q000235:genetics / Q000473:pathology*; D008297:Male; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications / Q000473:pathology*; D012367:RNA, Viral / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
D012367:RNA, Viral; D016159:Tumor Suppressor Protein p53