EBV positive primary cutaneous CD30+ large T-cell lymphoma in a heart transplanted patient: case report.
Most post-transplant lymphoproliferative disorders (PTLDs) are of B-cell origin, whereas T-cell lymphomas rarely occur. We detail the clinicopathological features of the first case of Epstein-Barr virus (EBV)-associated primary cutaneous CD30+ anaplastic large cell lymphoma (ALCL) in the setting of heart transplant. A 71-year-old patient, 111 months after transplant, presented with multiple cutaneous lesions on the left thigh; histological and immunohistochemical examinations led to diagnosis of T-cell CD30+ ALCL. In situ hybridization demonstrated the presence of EBV-positive tumour cells. The patient received radiotherapy, but he relapsed at the same cutaneous site with loco-regional nodal spread. Chemotherapy was administered resulting in complete remission; four years later the patient is alive and well. Our findings indicate that primary cutaneous EBV+ CD30+ ALCLs should be included within the T-cell PTLDs spectrum; further studies are required to confirm whether they may be also considered, in transplantation settings, a distinct lymphoma subset with relatively favourable outcome.
Anatomic Pathology Section, Department of Human Pathology, University of Pavia, I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
Marco
M
Lucioni
Giovanbattista
G
Ippoliti
Carlo
C
Campana
Dario
D
Cavallini
Paolo
P
Incardona
Alessandra
A
Viglio
Roberta
R
Riboni
Mario
M
Viganò
Umberto
U
Magrini
Marco
M
Paulli
D000368:Aged; D015703:Antigens, CD / Q000097:blood; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D006679:HIV Seropositivity; D016027:Heart Transplantation / Q000009:adverse effects*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007150:Immunohistochemistry; D017730:Ki-1 Antigen / Q000097:blood*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000276:immunology*; D008232:Lymphoproliferative Disorders / Q000150:complications*; D008297:Male; D011183:Postoperative Complications / Q000276:immunology; D012367:RNA, Viral / Q000032:analysis; D012878:Skin Neoplasms / Q000188:drug therapy / Q000276:immunology*; D016896:Treatment Outcome
D015703:Antigens, CD; D000970:Antineoplastic Agents; D017730:Ki-1 Antigen; D012367:RNA, Viral; D016572:Cyclosporine