Epstein-Barr virus-associated post-transplant lymphoproliferative disorder presenting with skin involvement after CD34-selected autologous peripheral blood stem cell transplantation.
We report a case of Epstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorder (PTLD) after CD34-selected autologous peripheral blood stem cell transplantation (PBSCT). A 54-year-old woman with multiple myeloma underwent CD34-selected autologous PBSCT. The patient's post-transplantation course was complicated by fever, pancytopenia and CMV antigenemia. On day 128 post PBSCT, a skin biopsy from an erythematous nodule on the right anterior chest revealed a deep dermal infiltrate of atypical CD20 and CD79a-positive B-cells with centroblastic large cell morphology. EBV reactivation was confirmed by immnohistochemistry, in situ hybridization and Southern blot analysis. These findings represent monomorphic PTLD having pathological features of a large cell-type B-cell lymphoma. Bone marrow aspiration also demonstrated hemophagocytic syndrome (HPS), accompanied with infiltration of EBV-positive B-cells. Despite treatment with rituximab and hydroxyurea, the patient died 155 days after transplantation.
Takahashi
Sanae
S
Department of Dermatology, Aichi Medical University, Nagakute, Aichi, Japan.
Watanabe
Daisuke
D
Miura
Kazuhisa
K
Ozawa
Hiroaki
H
Tamada
Yasuhiko
Y
Hara
Kazuo
K
Matsumoto
Yoshinari
Y
D018952:Antigens, CD34; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000209:etiology; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D012867:Skin / Q000473:pathology; D014182:Transplantation, Autologous
D018952:Antigens, CD34