Epstein-Barr virus-associated extranodal NK/T-cell lymphoma, nasal type of the hypopharynx, in a renal allograft recipient: case report and review of literature.
Posttransplant lymphoproliferative disorders (PTLPDs) are predominantly B-cell lymphoproliferations, whereas a T-cell origin is rarely observed. In contrast to B-cell PTLPD, T-cell PTLPDs show an inconsistent association with Epstein-Barr virus (EBV). Until now, only 13 cases of EBV-associated T-cell PTLPDs have been reported. We describe a case of an EBV-associated T-cell PTLPD in a renal allograft recipient 2 years after transplantation. Histologic examination showed medium- to large-sized lymphoid cells with an angiocentric growth pattern and necrosis. The atypical cells showed a CD2+, CD3epsilon+, CD7+, CD43+, CD45R0+, CD56+, and CD4-, CD5-, CD8- betaF1- phenotype with expression of the latent membrane protein (LMP)-1 of EBV. In addition, EBV-specific RNAs (EBER 1/2) were identified by in situ hybridization. Molecular analysis of the T-cell receptor (TCR) gamma chain by polymerase chain reaction (PCR) showed a polyclonal pattern. The morphologic, immunohistochemical, and molecular findings were consistent with a diagnosis of an EBV-associated extranodal natural killer (NK)/T-cell non-Hodgkin lymphoma (NHL) of nasal type. To our knowledge, this is the first reported case of this rare entity in the posttransplant setting.
Stadlmann
S
S
Department of Pathology, University of Innsbruck, Innsbruck, Austria.
Fend
F
F
Moser
P
P
Obrist
P
P
Greil
R
R
Dirnhofer
S
S
D000368:Aged; D015703:Antigens, CD / Q000032:analysis / Q000276:immunology; D020031:Epstein-Barr Virus Infections / Q000145:classification / Q000175:diagnosis* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000235:genetics; D006801:Humans; D007013:Hypopharynx / Q000473:pathology; D007150:Immunohistochemistry; D016130:Immunophenotyping; D016030:Kidney Transplantation; D007694:Killer Cells, Natural; D016399:Lymphoma, T-Cell / Q000145:classification / Q000175:diagnosis* / Q000821:virology; D008297:Male; D009305:Nasopharynx; D009894:Opportunistic Infections / Q000145:classification / Q000175:diagnosis* / Q000821:virology; D010610:Pharyngeal Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000821:virology; D012367:RNA, Viral / Q000032:analysis
D015703:Antigens, CD; D012367:RNA, Viral