title: EBV-associated polymorphic posttransplant lymphoproliferative disorder presenting as gingival ulcers.
abstract: Posttransplant lymphoproliferative disorders (PTLDs) present a wide clinicopathological spectrum, varying from the usual Epstein-Barr virus (EBV)-driven infectious mononucleosis-type polyclonal proliferations to EBV-positive or EBV-negative proliferations indistinguishable from overt lymphomas that occur in immunocompetent individuals. PTLDs characteristically have a predilection for extranodal sites and association with EBV.These disorders are usually B-cell type, although T-cell and rare cases involving both T- and B-cell types have also been described. The initial treatment consists in decreasing the immnosupressive therapy, usually with favorable results. The authors report on a rare case of a 19-year-old girl, with post-renal transplantation EBV-associated polymorphic lymphoproliferative gingival ulcerated lesions. To the best of their knowledge, this is the first case described in the English-language literature of polymorphic PTLD involving both B-cell and T-cell lineages, with an unusual immunoprofile affecting the mouth. The authors warn that this condition could be easily misdiagnosed as malignant lymphoma if not properly recognized.
authors.affiliation: Departmento de Diagnóstico Oral, Faculdade de Odontologia, Piracicaba Dental School, University of Campinas-UNICAMP, Piracicaba-SP, Brazil. jorgeesquiche@yahoo.com.br
authors.forename: Jorge Esquiche
authors.initials: JE
authors.lastname: León
authors.forename: Ademar
authors.initials: A
authors.lastname: Takahama Júnior
authors.forename: José
authors.initials: J
authors.lastname: Vassallo
authors.forename: Fernando Augusto
authors.initials: FA
authors.lastname: Soares
authors.forename: Oslei Paes
authors.initials: OP
authors.lastname: de Almeida
authors.forename: Márcio Ajudarte
authors.initials: MA
authors.lastname: Lopes
mesh_terms: D001402:B-Lymphocytes; D020031:Epstein-Barr Virus Infections; D004854:Herpesvirus 4, Human; D006801:Humans; D008232:Lymphoproliferative Disorders; D014456:Ulcer