[Epstein-Barr virus-related B-cell lymphoma of the skin which developed early after cord blood transplantation for angioimmunoblastic T-cell lymphoma].
We report here a rare case of EBV-related post-transplantation lymphoproliferative disorder (PTLD) localized to the skin. The patient was a 64-year-old man diagnosed with angioimmunoblastic T cell lymphoma (AITL). He underwent cord blood transplantation with a reduced intensity conditioning regimen during partial remission after chemotherapy. On day 70 after transplantation, subcutaneous tumors developed near the left scapula and in the left upper arm. Pathological examination of the skin tumor revealed that this tumor was composed of diffuse large centroblast-like cells, the majority of which were CD20 positive, CD 79a positive, CD30 positive and Epstein-Barr virus (EBV) latency-associated RNA (EBER) positive, and EBV-DNA was also detected in tumor cells. At that time, real-time polymerase chain reaction documented no evidence of the EBV genome in his blood. Chimerism analysis revealed that the tumor cells were derived from donor cells, which led to the diagnosis of EBV-related PTLD. For treatment, in addition to decreasing the dose of tacrolimus, we administered rituximab and local irradiation to skin lesions, which led to disappearance of the tumors followed by continued complete remission.
Tajika
Kenji
K
Department of Internal Medicine, Division of Hematology, Nippon Medical School.
Tamai
Hayato
H
Mizuki
Taro
T
Nakayama
Kazutaka
K
Yamaguchi
Hiroki
H
Dan
Kazuo
K
D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D005312:Fetal Blood / Q000637:transplantation*; D004854:Herpesvirus 4, Human; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000628:therapy*; D016399:Lymphoma, T-Cell / Q000628:therapy*; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000473:pathology / Q000628:therapy / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D000069283:Rituximab; D012871:Skin Diseases / Q000209:etiology / Q000473:pathology / Q000628:therapy / Q000821:virology*; D014019:Tissue Donors; D019172:Transplantation Conditioning; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab