Posttransplantation lymphoproliferative disease involving the pituitary gland.
Posttransplantation lymphoproliferative disorders (PTLD) are heterogeneous lesions with variable morphology, immunophenotype, and molecular characteristics. Multiple distinct primary lesions can occur in PTLD, rarely with both B-cell and T-cell characteristics. Lesions can involve both grafted organs and other sites; however, PTLD involving the pituitary gland has not been previously reported. We describe a patient who developed Epstein-Barr virus-negative PTLD 13 years posttransplantation involving the terminal ileum and pituitary, which was simultaneously involved by a pituitary adenoma. Immunohistochemistry of the pituitary lesion showed expression of CD79a, CD3, and CD7 with clonal rearrangements of both T-cell receptor gamma chain (TRG@) and immunoglobulin heavy chain (IGH@) genes. The terminal ileal lesion was immunophenotypically and molecularly distinct. This is the first report of pituitary PTLD and illustrates the potentially complex nature of PTLD.
Meriden
Zina
Z
Department of Pathology, University of Virginia Health System, PO Box 800214, Charlottesville, VA 22908, USA.
Bullock
Grant C
GC
Bagg
Adam
A
Bonatti
Hugo
H
Cousar
John B
JB
Lopes
M Beatriz
MB
Robbins
Mark K
MK
Cathro
Helen P
HP
D000236:Adenoma / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D000328:Adult; D015703:Antigens, CD / Q000378:metabolism; D002999:Clone Cells; D017809:Fatal Outcome; D005260:Female; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain; D015334:Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor; D006801:Humans; D007082:Ileum / Q000473:pathology; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007150:Immunohistochemistry; D016040:Lung Transplantation; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D010900:Pituitary Diseases / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D010902:Pituitary Gland / Q000378:metabolism / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D011183:Postoperative Complications
D015703:Antigens, CD; D007143:Immunoglobulin Heavy Chains