title: Epstein-Barr virus-associated smooth muscle tumors in a composite tissue allograft and a pediatric liver transplant recipient.
abstract: Epstein-Barr virus (EBV) is known to establish latent infections in B-lymphocytes that can cause lymphoproliferative disorders particularly in immunocompromised patients. More recently, the development of rare EBV-associated smooth muscle tumors has been reported in transplant recipients. We herein describe 2 new cases of EBV-associated post-transplant smooth muscle tumors (EBV-PTSMT), including the first in a facial composite tissue graft recipient. Among the striking features shared by these 2 patients were their young ages, the fact that they were naïve for EBV before the transplantation, that they developed a post-transplant lymphoproliferative disorder before the diagnosis of EBV-PTSMT, and that they responded favorably to reduction of immunosuppression. Radiological and histologic features of EBV-PTSMT are shown. Finally, pathophysiology and therapeutic management of EBV-PTSMT are discussed based on a comprehensive review of the literature.
authors.affiliation: Service de Transplantation, Néphrologie et Immunologie Clinique, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France.
authors.forename: A
authors.initials: A
authors.lastname: Conrad
authors.forename: A-S
authors.initials: AS
authors.lastname: Brunet
authors.forename: V
authors.initials: V
authors.lastname: Hervieu
authors.forename: C
authors.initials: C
authors.lastname: Chauvet
authors.forename: F
authors.initials: F
authors.lastname: Buron
authors.forename: S
authors.initials: S
authors.lastname: Collardeau-Frachon
authors.forename: C
authors.initials: C
authors.lastname: Rivet
authors.forename: P
authors.initials: P
authors.lastname: Cassier
authors.forename: S
authors.initials: S
authors.lastname: Testelin
authors.forename: A
authors.initials: A
authors.lastname: Lachaux
authors.forename: E
authors.initials: E
authors.lastname: Morelon
authors.forename: O
authors.initials: O
authors.lastname: Thaunat
mesh_terms: D000328:Adult; D064591:Allografts; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy / Q000821:virology; D054445:Facial Transplantation / Q000009:adverse effects*; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects*; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D018235:Smooth Muscle Tumor / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy / Q000821:virology
keywords: Epstein-Barr virus; PTLD; composite tissue allotransplantation; face transplantation; post-transplant lymphoproliferative disorders; post-transplant smooth muscle tumors