title: B-cell posttransplant lymphoproliferative disorder isolated to the central nervous system is Epstein-Barr virus positive and lacks p53 and Myc expression by immunohistochemistry.
abstract: In this retrospective study from one institution, we performed a clinicopathological study of a cohort of patients with posttransplant lymphoproliferative disorder (PTLD) confined to the central nervous system. We also identified a comparison cohort of patients with de novo primary diffuse large B-cell lymphoma of the central nervous system. We performed a detailed morphologic review, evaluated Epstein-Barr virus (EBV) by in situ hybridization, and interpreted a panel of immunohistochemical stains in a subset of cases including Hans classification markers (CD10, BCL6, MUM1), p53, CD30, Myc, and BCL2. All 17 of the posttransplant and none of 11 de novo cases were EBV positive (P < .005). Morphologic patterns identified in the PTLD cases were monomorphic diffuse large B-cell lymphoma pattern (10 patients) and "T-cell-rich" pattern (7 patients). The monomorphic posttransplant cases were more likely to be Myc negative (P = .015) and CD30 positive (P < .005) than the de novo cases, and showed a similarly low rate of p53 positivity by immunohistochemistry. No prognostic factors for overall survival were identified. Central nervous system PTLD is EBV positive, typically lacks p53 and Myc expression by immunohistochemistry, and can present with numerous background T lymphocytes.
authors.affiliation: University of Minnesota Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Sundin
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA.
authors.forename: Bartosz J
authors.initials: BJ
authors.lastname: Grzywacz
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA.
authors.forename: Sophia
authors.initials: S
authors.lastname: Yohe
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Linden
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA. Electronic address: ecourvil@umn.edu.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Courville
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001402:B-Lymphocytes / Q000737:chemistry* / Q000276:immunology / Q000473:pathology / Q000821:virology; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D016543:Central Nervous System Neoplasms / Q000737:chemistry* / Q000276:immunology / Q000473:pathology / Q000821:virology; D020805:Central Nervous System Viral Diseases / Q000276:immunology / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D002648:Child; D020031:Epstein-Barr Virus Infections / Q000276:immunology / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D016403:Lymphoma, Large B-Cell, Diffuse / Q000737:chemistry* / Q000276:immunology / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D016377:Organ Transplantation / Q000009:adverse effects*; D011237:Predictive Value of Tests; D016271:Proto-Oncogene Proteins c-myc / Q000032:analysis; D012367:RNA, Viral / Q000235:genetics; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000737:chemistry / Q000276:immunology / Q000473:pathology / Q000821:virology; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; C489427:MYC protein, human; D016271:Proto-Oncogene Proteins c-myc; D012367:RNA, Viral; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53
keywords: Central nervous system lymphoma; Myc; PTLD; Posttransplant lymphoproliferative disorder; p53