The efficacy of EBER in situ hybridization (ISH) stain in PTLD (malignant diffuse large B-cell lymphoma) about 4 years after ABO-incompatible kidney transplantation: a case report.
Post-transplant lymphoproliferative disease (PTLD) is a well-known late complication of organ transplantation which incidence has increased after the introduction of more powerful immunosuppressive agents. A 58-year-old man performed ABO-incompatible living kidney transplantation in June, 2008. At 3 years and 9 months after the transplantation, the patient complained of general fatigue and dyspnea and was hospitalized with renal dysfunction. The clinical data in hospital showed acute rejection, but soluble IL-II exceeded 21700U/ml, and HE staining kidney graft showed a massive infiltration of atypical lymphocytes. Atypical lymphocytes were positive for L-26 and negative for CD3 immunochemical stein, and the EBER in situ hybridization stain for EBV was negative in renal graft. We diagnosed diffuse large B-cell lymphoma in the kidney graft. However, he died due to multiple organ failure (MOF). We described a fatal case of diffuse large B-cell lymphoma without EBV infection occurring 3 years 9 months after ABO-incompatible kidney transplantation. Unfortunately, post-mortem autopsy using EBER-ISH stain does not show whether EB virus infection was a cause.
Department of Urology, Kinki University faculty of Medicine Sakai Hospital, Sakai city, Japan. kams.nose@sakai.med.kindai.ac.jp
Kazuhiro
K
Nose
Takashi
T
Oki
Eri
E
Banno
Koichi
K
Sugimoto
Tsukasa
T
Nishioka
Ken
K
Ochiai
Syunji
S
Maekura
D000017:ABO Blood-Group System / Q000276:immunology*; D001344:Autopsy; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D020031:Epstein-Barr Virus Infections / Q000276:immunology / Q000821:virology*; D017809:Fatal Outcome; D004854:Herpesvirus 4, Human / Q000235:genetics*; D006648:Histocompatibility; D006801:Humans; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000009:adverse effects; D017403:In Situ Hybridization; D016030:Kidney Transplantation / Q000276:immunology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000276:immunology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000017:ABO Blood-Group System; D014408:Biomarkers, Tumor; D007166:Immunosuppressive Agents; D012367:RNA, Viral