title: Epstein-Barr virus associated post-transplant Hodgkin lymphoma in an adult patient after cord blood stem cell transplantation for acute lymphoblastic leukemia.
abstract: Post-transplant lymphoproliferative disorder (PTLD) is one of the most important complications of solid organ transplantation or hematopoietic stem cell transplantation. Most PTLDs are associated with Epstein-Barr virus (EBV) infection. Although post-transplant Hodgkin lymphoma (HL) is included in PTLD, there have been no studies in the literature on adult cases of post-transplant HL after cord blood stem cell transplantation (CBSCT). This is due to the fact that EBV infection of cord blood cells usually does not occur, and EBV-infected lymphocytes of the recipient should be eradicated by preconditioning therapy. We report a 26-year-old woman case of post-transplant HL, which occurred after CBSCT for relapsed acute lymphoblastic leukemia. Three years and eight months after CBSCT, the enlarged cervical lymph node was histologically diagnosed as EBV associated post-transplant HL, which showed immunophenotypes of classical HL and latency type II EBV infection. She underwent chemotherapy, and has survived 4 years and 6 months after CBSCT. Differential diagnosis of post-transplant HL with good prognosis and HL-like PTLD with aggressive behavior is important, and immunohistochemical methods were useful and essential for it. The source of EBV associated HL in this case will be discussed.
authors.affiliation: Division of Molecular Pathology, Tottori University, Faculty of Medicine. kokuno53@med.tottori-u.ac.jp
authors.forename: Keisuke
authors.initials: K
authors.lastname: Okuno
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Horie
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Kanai
authors.forename: Masako
authors.initials: M
authors.lastname: Kato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuwamoto
authors.forename: Toshiro
authors.initials: T
authors.lastname: Okazaki
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Hayashi
mesh_terms: D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D003937:Diagnosis, Differential; D020031:Epstein-Barr Virus Infections / Q000209:etiology; D005260:Female; D004854:Herpesvirus 4, Human; D006689:Hodgkin Disease / Q000175:diagnosis / Q000209:etiology* / Q000821:virology; D006801:Humans; D016609:Neoplasms, Second Primary / Q000188:drug therapy / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D055815:Young Adult