EBV-associated B- and T-cell posttransplant lymphoproliferative disorders following primary EBV infection in a kidney transplant recipient.
Posttransplant lymphoproliferative disorders (PTLDs) usually are of B-cell lineage and associated with Epstein-Barr virus (EBV). PTLDs of T-cell lineage are much less common and infrequently associated with EBV. We report a rare case of a girl in whom B-cell and T-cell PTLDs developed following 2 EBV-negative kidney transplants. Within 2 years of the second transplantation, the originally EBV-negative patient developed both an EBV-associated clonal B-cell PTLD involving lymph nodes and an EBV-positive T-cell PTLD involving bone marrow and liver. These proliferations occurred concurrently with evidence of primary EBV infection and high plasma viral load. The patient eventually died of multiorgan failure 5 years after the initial transplant (3 years after the second transplant). To our knowledge, only 4 cases of both B-cell and T-cell PTLDs have been reported. Only 2 cases have been proven to be monoclonal and EBV-associated, as in this case, the first following kidney transplantation.
Yin
C Cameron
CC
Department of Hematopathology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Medeiros
L Jeffrey
LJ
Abruzzo
Lynne V
LV
Jones
Dan
D
Farhood
Anwar I
AI
Thomazy
Vilmos A
VA
D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology*; D001853:Bone Marrow / Q000473:pathology / Q000821:virology; D049109:Cell Proliferation; D002675:Child, Preschool; D002999:Clone Cells; D004273:DNA, Neoplasm / Q000032:analysis; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000235:genetics / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D015334:Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor / Q000235:genetics; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D016130:Immunophenotyping; D016030:Kidney Transplantation; D008099:Liver / Q000473:pathology / Q000821:virology; D008198:Lymph Nodes / Q000473:pathology / Q000821:virology; D008232:Lymphoproliferative Disorders / Q000235:genetics / Q000473:pathology* / Q000821:virology; D011183:Postoperative Complications; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology*
D004273:DNA, Neoplasm