An unusual presentation of post-transplant lymphoproliferative disorder mimicking vasculitis in heart transplantation.
This report details an unusual case of Epstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorder (PTLD) involving the epicardial coronary arteries and myocardial arterioles of an allograft heart, morphologically mimicking vasculitis, a finding associated with acute rejection, cardiac allograft vasculopathy (CAV), infection and infarction. Recognition of this novel PTLD pattern as a potential imitator of acute rejection in particular is important because reduction of immunosuppression (to treat PTLD) is antithetical to the usual therapy for rejection.
Murray
David L
DL
Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Pereira
Naveen L
NL
Miller
Dylan V
DV
D001344:Autopsy; D001706:Biopsy; D006328:Cardiac Catheterization; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology; D017548:Echocardiography, Transesophageal; D004487:Edema / Q000209:etiology; D017809:Fatal Outcome; D016027:Heart Transplantation / Q000009:adverse effects* / Q000473:pathology; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000473:pathology; D014657:Vasculitis / Q000175:diagnosis*