title: Presence of p16 hypermethylation and Epstein-Barr virus infection in transplant-associated hematolymphoid neoplasm of the skin.
abstract: BACKGROUND
  Epstein-Barr virus (EBV) is associated with the malignant transformation of B, T, and NK lymphocytes in humans, especially in immunosuppressed individuals.
  
  
  OBJECTIVE
  We describe an unusual case confined to the skin in a 39-year-old African American female following a renal transplant.
  
  
  METHODS
  Morphologically and immunophenotypically, the tumor was best classified as a plasmablastic lymphoma; however, the neoplastic population revealed rearrangements of both immunoglobulin heavy chain (IgG) and T cell receptor gamma (TCR-gamma). In situ hybridization demonstrated the presence of Epstein-Barr early RNA species (EBER) in the lymphoma cells, consistent with EBV infection.
  
  
  RESULTS
  We have previously demonstrated that EBV-induced reactive oxygen is associated with hypermethylation of the tumor suppressor gene p16 in Burkitt lymphoma, and that p16 hypermethylation is nearly always associated with EBV infection in Burkitt lymphoma.
  
  
  CONCLUSIONS
  Further studies are needed to determine whether p16 is widely suppressed in immunosuppression-induced lymphoma.
  
  
  CONCLUSIONS
  In this study, we demonstrated high levels of hypermethylation of the tumor suppressor gene p16, thus supporting the role of EBV as a carcinogen in post-transplant lymphoproliferative disease.
authors.affiliation: Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia 30322, USA. jarbise@emory.edu
authors.forename: Jack L
authors.initials: JL
authors.lastname: Arbiser
authors.forename: Karen P
authors.initials: KP
authors.lastname: Mann
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Losken
authors.forename: Cynthia
authors.initials: C
authors.lastname: Cohen
authors.forename: Kalpana
authors.initials: K
authors.lastname: Reddy
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kokko
authors.forename: Brian
authors.initials: B
authors.lastname: Pollack
authors.forename: Chung-Yang
authors.initials: CY
authors.lastname: Fan
authors.forename: Fiona
authors.initials: F
authors.lastname: O'Reilly
mesh_terms: D000328:Adult; D019175:DNA Methylation; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D019942:Genes, p16; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008223:Lymphoma / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics / Q000821:virology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics / Q000821:virology