Post-transplant lymphoproliferative disorder limited to the skin.
BACKGROUND
Post-transplant lymphoproliferative disorder (PTLD) is a condition affecting immunosuppressed transplant patients and has a variety of clinical presentations. It is rarely found in the skin, and cases of PTLD in the skin are usually linked with lymph node or other organ involvement.


METHODS
We report a case of plasmacytoid PTLD that is limited to the skin. A 63-year-old man with a history of cardiac transplant presented with exophytic tumors involving the lower extremity. The diagnosis and classification of the various forms of PTLD are discussed.


RESULTS
Histology, immunohistochemical stains, and in situ hybridization revealed an aggressive plasmacytoid tumor that was Epstein-Barr virus positive. The patient's tumors resolved with decreased immunosuppression and localized radiation.


CONCLUSIONS
This case is unusual for several reasons including involvement limited to the skin, presentation 15 years following transplant, and plasmacytoid phenotype of the tumor. This disorder will likely be seen by dermatologists and dermatopathologists with the increasing use of immunosuppressive medications in the dermatologist's patient population.
Samolitis
Nancy J
NJ
Departments of Dermatology and Hematology-Oncology, University of Utah, Salt Lake City, USA. nancysamolitis@yahoo.com
Bharadwaj
Jayaram S
JS
Weis
John R
JR
Harris
Ronald M
RM
D020031:Epstein-Barr Virus Infections / Q000276:immunology; D016027:Heart Transplantation / Q000009:adverse effects*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000209:etiology* / Q000473:pathology* / Q000821:virology