title: Posttransplantation lymphoproliferative disease involving the pituitary gland.
abstract: 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.
authors.affiliation: Department of Pathology, University of Virginia Health System, PO Box 800214, Charlottesville, VA 22908, USA.
authors.forename: Zina
authors.initials: Z
authors.lastname: Meriden
authors.forename: Grant C
authors.initials: GC
authors.lastname: Bullock
authors.forename: Adam
authors.initials: A
authors.lastname: Bagg
authors.forename: Hugo
authors.initials: H
authors.lastname: Bonatti
authors.forename: John B
authors.initials: JB
authors.lastname: Cousar
authors.forename: M Beatriz
authors.initials: MB
authors.lastname: Lopes
authors.forename: Mark K
authors.initials: MK
authors.lastname: Robbins
authors.forename: Helen P
authors.initials: HP
authors.lastname: Cathro
mesh_terms: 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
chemical_list: D015703:Antigens, CD; D007143:Immunoglobulin Heavy Chains