Post-transplant T-cell lymphoproliferative disorder/T-cell lymphoma: a report of three cases of T-anaplastic large-cell lymphoma with cutaneous presentation and a review of the literature.
OBJECTIVE
To report the clinical, pathological and immunohistochemical features of three cases of post-transplant T-cell lymphoproliferative disorder (T-PTLD) T-cell lymphoma with primary cutaneous presentation.


RESULTS
Three cases of primary cutaneous post-transplantation anaplastic large-cell lymphomas occurred in renal transplant recipients and were shown to display a T-cell immunophenotype; all were ALK 1 protein and EMA negative and two were Epstein-Barr virus positive using in-situ hybridization. Two displayed a CD4+ phenotype, two were focally CD56+ and all three were negative for the cytolytic enzyme granzyme B. In two cases monoclonality was established by T-cell receptor gene rearrangement study. All presented with nodular cutaneous involvement and all were ultimately fatal.


CONCLUSIONS
T-PTLDs are uncommon histological subtypes both in a general context and associated with cutaneous presentation. Our findings suggest clinicopathological and immunophenotypic similarities to primary cutaneous anaplastic large-cell lymphoma but with a progressive clinical behaviour similar to previously reported T-PTLD and to systemic nodal ALK- anaplastic large-cell lymphoma.
Coyne
J D
JD
Department of Histopathology, Withenshawe Hospital, Manchester, UK.
Banerjee
S S
SS
Bromley
M
M
Mills
S
S
Diss
T C
TC
Harris
M
M
D000328:Adult; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D016030:Kidney Transplantation; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D016403:Lymphoma, Large B-Cell, Diffuse / Q000503:physiopathology*; D016399:Lymphoma, T-Cell / Q000503:physiopathology*; D008232:Lymphoproliferative Disorders / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000503:physiopathology*