title: Primary intestinal posttransplant T-cell lymphoma.
abstract: 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.
authors.affiliation: Division of Nephrology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10467, USA.
authors.forename: J
authors.initials: J
authors.lastname: Michael
authors.forename: S
authors.initials: S
authors.lastname: Greenstein
authors.forename: R
authors.initials: R
authors.lastname: Schechner
authors.forename: V
authors.initials: V
authors.lastname: Tellis
authors.forename: L V
authors.initials: LV
authors.lastname: Vasovic
authors.forename: H
authors.initials: H
authors.lastname: Ratech
authors.forename: D
authors.initials: D
authors.lastname: Glicklich
mesh_terms: 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*
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus