Primary intestinal posttransplant T-cell lymphoma.
There have been only five reported cases of primary posttransplant T-cell lymphoma. We report the first case associated with the use of sirolimus (Rapamycin, Wyeth-Ayerst, Philadelphia, PA). The patient, receiving prednisone, cyclosporine, and sirolimus treatment, developed ascites, diarrhea, and weight loss 7 months after his second renal transplant. Tissue obtained at laparotomy established the diagnosis of primary T-cell lymphoma. Latent membrane protein-1 for Epstein-Barr virus was negative, but in-site hybridization test for Epstein-Barr-encoded RNA was positive. Despite aggressive chemotherapy, the patient died 8 months posttransplant. This is the sixth reported case of primary intestinal posttransplant T-cell lymphoma, but it is the first case associated with the use of sirolimus. The incidence of posttransplant lymphoproliferative disease in patients receiving sirolimus should be studied.
Michael
J
J
Division of Nephrology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10467, USA.
Greenstein
S
S
Schechner
R
R
Tellis
V
V
Vasovic
L V
LV
Ratech
H
H
Glicklich
D
D
D017809:Fatal Outcome; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007414:Intestinal Neoplasms / Q000139:chemically induced* / Q000473:pathology; D016030:Kidney Transplantation / Q000276:immunology*; D016399:Lymphoma, T-Cell / Q000139:chemically induced / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology; D020123:Sirolimus / Q000009:adverse effects*
D007166:Immunosuppressive Agents; D020123:Sirolimus